Etiology
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Acute rheumatic fever is a systemic disease of childhood, often recurrent that follows group A beta hemolytic streptococcal infection.
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It is a diffuse inflammatory disease of connective tissue, primarily involving heart, blood vessels, joints, subcutaneous tissues and CNS
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It is a delayed non-suppurative sequelae to URTI with GABH streptococci.
Microbe Group A Streptococcus
Features of Acute Rheumatic Fever
- Autoimmune consequence of infection with Group A streptococcal infection
- Results in a generalised inflammatory response affecting brains, joints, skin, subcutaneous tissues and the heart.
- The clinical presentation can be vague and difficult to diagnose.
- Currently the modified Duckett-Jones criteria form the basis of the diagnosis of the condition. History is primary way to diagnose rheumatic fever
Therapeutics of Rheumatic Fever Treatment
Surgical CareY
When heart failure persists or worsens after aggressive medical therapy for acute rheumatic heart disease, surgery to decrease valve insufficiency may be life-saving.
40%of patients with acute rheumatic heart disease subsequently develop mitral stenosis as adults.
valve replacement appears to be the preferred surgical option
PrognosisY
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Rheumatic fever can recur whenever the individual experience new GABH streptococcal infection,if not on prophylactic medicines
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Good prognosis for older age group & if no carditis during the initial attack
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Bad prognosis for younger children & those with carditis with valvar lesions