Rheumatic fever |
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Authors: | Eugenia Rullan and Leonard H Sigal |
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Institution: | (1) Department of Medicine, Division of Rheumatology, UMDNJ-Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, PO Box 19, MEB-484, 08903-0019 New Brunswick, NJ, USA |
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Abstract: | Rheumatic fever is a multisystem inflammatory disease that occurs as a delayed sequel to group A streptococcal pharyngitis.
It is less common than it was 50 years ago but is still a major cause of heart disease in developing areas of the world. The
relationship between the site of infection, the type of causative organism, and susceptibility of the host is essential in
the development of the disease. Its major clinical manifestations include carditis, migratory polyarthritis, chorea, erythema
marginatum, and subcutaneous nodules. It can manifest as an acute febrile illness consisting of migratory polyarthritis involving
the large joints, as carditis and valvulitis, or as Sydenham’s chorea with involvement of the central nervous system. The
disorder in its milder form resolves itself without sequelae. Carditis is the condition most associated with increased mortality
and morbidity and may be fatal in its severe forms. Penicillin is the most appropriate primary and secondary prophylaxis.
Antiinflammatory agents provide symptomatic relief but do not prevent rheumatic heart disease. |
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