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Rheumatic Fever

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  1. Rheumatic Fever Rheumatic Fever

  2. Introduction Rheumatic fever is an inflammatory disease that occurs following a Streptococcus pyogenes infection, such as streptococcal pharyngitis or scarlet fever. Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain.

  3. Rheumatic heart disease Chronic rheumatic heart disease (RHD) is characterized by repeated inflammation with fibrinous resolution. The cardinal anatomic changes of the valve include leaflet thickening, commissural fusion, and shortening and thickening of the tendinouscords.It is caused by an autoimmune reaction to Group A β-hemolytic streptococci (GAS) that results in valvular damage.

  4. Treatment The management of acute rheumatic fever is geared toward the reduction of inflammation with anti-inflammatory medications such as aspirin or corticosteroids. Individuals with positive cultures for strep throat should also be treated with antibiotics. Aspirin is the drug of choice and should be given at high doses.

  5. Epidemiology Rheumatic fever is common worldwide and responsible for many cases of damaged heart valves. Rheumatic fever primarily affects children between ages 5 and 17 years and occurs approximately 20 days after strep throat. In up to a third of cases, the underlying strep infection may not have caused any symptoms.