Rheumatic fever (RF)

Rheumatic fever

it is an inflammatory disease of the connective tissues involving mainly the heart and joints ,it has a high tendency to recur.

Cause

it occures in a person who reacts abnormally to GABS infection 👌🏻

Clinical picture 

Major criteria

• Migratory Polyarthritis 
• carditis
• chorea
• erythema marginatum
• subcutaneous nodules

Minor criteria

• Fever 38.5
• arthralgia
• elevates ESR and CRP
• prolonged P-R interval on ECG

Plus the presence of GABS infection

To diagnose you should have either 2 majors and GABS or one major,one two minors and GABS👌🏻👌🏻

Presence of GABS can be detected by positive culture of the throat,elevated ASO titre,positive rapid test for streptococcal and history of scarlet fever 🤒 

Management of RF

• Treatment of GABS

Penicillin 👌🏻👌🏻👌🏻

Single IM dose of 600.000 U for <27kg or 1200.000 U for >27kg of benzathine penicillin

if the patient is allergic you can replace it with erythromycin or amoxicillin or cefadroxil for 10 days orally 40mg/kg/day

• Treatment of the inflammation 

By acetylsalicylic acid and if there is carditis you can use prednisone 

• Treatment of any complications 
• prevention of recurrence by

Early and adequate treatment of GABS during the first week ,this is called primary prevention 

or you can give the patient benzathinepenicillin 1200.000U every 2-3 weeks until 21y old .