Acute Rheumatic Fever
It is a disease caused after streptococcal bacterial infection. It usually follows 2 weeks after Pharyngitis mainly affecting Major organs of the body, Heart, Joints, and Brain. If untreated it leads to Rheumatic Heart Disease in 2-3% cases. It can also lead to CCF (Congestive Cardiac Failure) & less contractility.
Symptoms include
- Fever up to 102-108f
- Migratory Polyarthritis at joints mainly affecting larger joints Ankle, Elbow
Five major criteria for detecting or diagnosing Acute Rheumatic Fever (John's Criteria)
- Migratory Arthritis (Pain moves from one joint to another)
- Subcutaneous nodules
- Chorea ( Purposeless movements of usually face and arms)
- Erythema Marginatum which is Skin Rash
- Cardia Involvement ( CCF, Less Contractility of heart or Rheumatic Heart Disease)
Minor Criteria Includes:
- Fever
- Recurrent Pain
Baseline investigations like ASO titer, CBC with ESR, Echocardiography, ECG and X-ray Chest and Nasopharyngeal swab
Lab findings show
- Increased Leukocytes Count
- Increased ESR
- On ECG the PR interval is prolonged
- Streptococci on Nasopharyngeal Swab
Diagnosis is based on Johns criteria like major symptoms are present and lab finding suggest the disease.
Treatment:
Usually, as a prophylaxis 1-2 ml, Penicillin per month is given up to the age 40 in patients who had previously this disease.
Acute disease is treated with Aspirin+corticosteroids 100mg/kg per body weight.
A measure is taken to reduce fever and arthritis with symptomatic treatment.
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