Rheumatic fever is an autoimmune disease that can develop after a streptococcal throat infection. It causes inflammation in various body systems like the heart, joints, brain and skin. The pathogenesis involves antibodies produced against streptococci that cross-react with human tissues due to molecular mimicry. Rheumatic fever is diagnosed using the modified Jones criteria and treated with antibiotics to eliminate the streptococcal infection as well as anti-inflammatory drugs. Long-term prevention involves continued antibiotic prophylaxis to prevent recurrent attacks that can lead to chronic rheumatic heart disease.
This document discusses cardiovascular system infections, including infective endocarditis. Some key points:
- Infective endocarditis is an infection of the heart valves that can have mortality rates as high as 20-50% despite antibiotic treatment.
- Predisposing factors for infective endocarditis include congenital heart defects, rheumatic heart disease, intravenous drug use, and degenerative cardiac diseases.
- Subacute infective endocarditis typically has a chronic course and is caused by less virulent organisms like streptococci that infect damaged heart valves, forming large vegetations. It accounts for 70% of cases.
- Acute infective endocarditis has a rapidly progressive course
Rheumatic fever is an autoimmune disease that can develop as a result of a streptococcal throat infection. It causes inflammation of the heart, joints, brain, and skin. The disease is most common in children ages 5-15 in developing countries. It is diagnosed using the Modified Jones Criteria which looks for major criteria like heart inflammation, arthritis, subcutaneous nodules, and minor criteria like fever and joint pain along with evidence of a prior streptococcal infection. Treatment involves antibiotics to treat the infection as well as medications for symptoms while long term prevention relies on regular antibiotics.
Rheumatic fever is a non-suppurative sequelae to group A streptococcal pharyngitis that causes inflammation in connective tissues like heart, blood vessels, joints, and brain. It is most common in children ages 5-15 from developing countries. The disease is caused by an abnormal immune response 1-3 weeks after streptococcal infection. Symptoms include migratory arthritis, heart valve damage, chorea, and subcutaneous nodules. Diagnosis is based on modified Jones criteria. Treatment involves antibiotics for streptococcal infection, aspirin or steroids for inflammation, and lifelong antibiotic prophylaxis to prevent recurrence, especially if carditis is present. Prognosis depends on age and whether
The document discusses several common pediatric acquired heart diseases, with a focus on rheumatic fever and rheumatic heart disease. It describes the etiology, pathogenesis, clinical features, diagnosis, treatment and prevention of acute rheumatic fever. Long-term, recurrent rheumatic fever can lead to rheumatic heart disease, causing valvular lesions primarily of the mitral and aortic valves.
Acute rheumatic fever is an immune-mediated disease that can develop weeks after a Group A streptococcal throat infection. It commonly affects the heart, joints, skin, and brain in children ages 5-15. The disease is caused by an abnormal immune response to the bacterial infection. Symptoms may include migratory arthritis, heart inflammation (carditis), abnormal movements (chorea), and skin nodules or rashes. Diagnosis is based on the modified Jones criteria and treatment involves antibiotics, anti-inflammatories, and long-term prevention of recurrent episodes through antibiotics. Untreated, it can lead to permanent heart valve damage known as rheumatic heart disease.
Rheumatic fever is an inflammatory disease that occurs after a streptococcal throat infection and can damage the heart valves. It is most common in school-aged children and adolescents. The symptoms involve the joints, skin, brain and heart. Diagnosis is based on guidelines that evaluate symptoms and lab tests. Treatment focuses on eradicating streptococci, reducing inflammation, managing complications, and long-term prophylaxis to prevent recurrence. Untreated rheumatic fever can lead to rheumatic heart disease, permanent damage to the heart valves.
Rheumatic heart disease is an autoimmune condition that can develop after a streptococcal throat infection. The bacteria produces antigens that are similar to heart tissue, leading to molecular mimicry where the immune system attacks the heart. Approximately 3% of untreated streptococcal infections lead to rheumatic fever, which can cause inflammation of the heart valves and joints. Repeated bouts of rheumatic fever over time can cause scarring of the heart valves, leading to stenosis or incompetence requiring valve replacement. Treatment involves antibiotics to prevent future streptococcal infections, while prophylaxis aims to protect those with a history of rheumatic fever from additional attacks.
Rheumatic heart disease is an autoimmune condition that can develop after a streptococcal throat infection. The bacteria produces antigens that are similar to heart tissue, leading to molecular mimicry where the immune system attacks the heart. Approximately 3% of untreated streptococcal infections lead to rheumatic fever, which can cause inflammation of the heart valves and joints. Repeated bouts of rheumatic fever over time can cause scarring of the heart valves, leading to stenosis or incompetence that may require valve replacement. Treatment involves antibiotics to prevent future streptococcal infections, while prophylaxis aims to protect those with a history of rheumatic fever from additional attacks.
This document discusses cardiovascular system infections, including infective endocarditis. Some key points:
- Infective endocarditis is an infection of the heart valves that can have mortality rates as high as 20-50% despite antibiotic treatment.
- Predisposing factors for infective endocarditis include congenital heart defects, rheumatic heart disease, intravenous drug use, and degenerative cardiac diseases.
- Subacute infective endocarditis typically has a chronic course and is caused by less virulent organisms like streptococci that infect damaged heart valves, forming large vegetations. It accounts for 70% of cases.
- Acute infective endocarditis has a rapidly progressive course
Rheumatic fever is an autoimmune disease that can develop as a result of a streptococcal throat infection. It causes inflammation of the heart, joints, brain, and skin. The disease is most common in children ages 5-15 in developing countries. It is diagnosed using the Modified Jones Criteria which looks for major criteria like heart inflammation, arthritis, subcutaneous nodules, and minor criteria like fever and joint pain along with evidence of a prior streptococcal infection. Treatment involves antibiotics to treat the infection as well as medications for symptoms while long term prevention relies on regular antibiotics.
Rheumatic fever is a non-suppurative sequelae to group A streptococcal pharyngitis that causes inflammation in connective tissues like heart, blood vessels, joints, and brain. It is most common in children ages 5-15 from developing countries. The disease is caused by an abnormal immune response 1-3 weeks after streptococcal infection. Symptoms include migratory arthritis, heart valve damage, chorea, and subcutaneous nodules. Diagnosis is based on modified Jones criteria. Treatment involves antibiotics for streptococcal infection, aspirin or steroids for inflammation, and lifelong antibiotic prophylaxis to prevent recurrence, especially if carditis is present. Prognosis depends on age and whether
The document discusses several common pediatric acquired heart diseases, with a focus on rheumatic fever and rheumatic heart disease. It describes the etiology, pathogenesis, clinical features, diagnosis, treatment and prevention of acute rheumatic fever. Long-term, recurrent rheumatic fever can lead to rheumatic heart disease, causing valvular lesions primarily of the mitral and aortic valves.
Acute rheumatic fever is an immune-mediated disease that can develop weeks after a Group A streptococcal throat infection. It commonly affects the heart, joints, skin, and brain in children ages 5-15. The disease is caused by an abnormal immune response to the bacterial infection. Symptoms may include migratory arthritis, heart inflammation (carditis), abnormal movements (chorea), and skin nodules or rashes. Diagnosis is based on the modified Jones criteria and treatment involves antibiotics, anti-inflammatories, and long-term prevention of recurrent episodes through antibiotics. Untreated, it can lead to permanent heart valve damage known as rheumatic heart disease.
Rheumatic fever is an inflammatory disease that occurs after a streptococcal throat infection and can damage the heart valves. It is most common in school-aged children and adolescents. The symptoms involve the joints, skin, brain and heart. Diagnosis is based on guidelines that evaluate symptoms and lab tests. Treatment focuses on eradicating streptococci, reducing inflammation, managing complications, and long-term prophylaxis to prevent recurrence. Untreated rheumatic fever can lead to rheumatic heart disease, permanent damage to the heart valves.
Rheumatic heart disease is an autoimmune condition that can develop after a streptococcal throat infection. The bacteria produces antigens that are similar to heart tissue, leading to molecular mimicry where the immune system attacks the heart. Approximately 3% of untreated streptococcal infections lead to rheumatic fever, which can cause inflammation of the heart valves and joints. Repeated bouts of rheumatic fever over time can cause scarring of the heart valves, leading to stenosis or incompetence requiring valve replacement. Treatment involves antibiotics to prevent future streptococcal infections, while prophylaxis aims to protect those with a history of rheumatic fever from additional attacks.
Rheumatic heart disease is an autoimmune condition that can develop after a streptococcal throat infection. The bacteria produces antigens that are similar to heart tissue, leading to molecular mimicry where the immune system attacks the heart. Approximately 3% of untreated streptococcal infections lead to rheumatic fever, which can cause inflammation of the heart valves and joints. Repeated bouts of rheumatic fever over time can cause scarring of the heart valves, leading to stenosis or incompetence that may require valve replacement. Treatment involves antibiotics to prevent future streptococcal infections, while prophylaxis aims to protect those with a history of rheumatic fever from additional attacks.
Rheumatic fever is an inflammatory disease that affects the heart, joints, skin, and brain. It occurs as a result of a prior streptococcal throat infection. The body mounts an immune response against the bacteria that cross-reacts with human tissues, causing damage. Common manifestations include painful migratory arthritis, inflammation of the heart valves, and involuntary movements known as Sydenham's chorea. Rheumatic fever predominantly affects children in developing countries and can lead to the chronic rheumatic heart disease if heart valves are damaged. Diagnosis is based on clinical criteria and evidence of a preceding streptococcal infection.
This document discusses acute rheumatic fever and rheumatic heart disease. It begins by outlining the objectives of understanding the epidemiology, pathogenesis, clinical features, laboratory studies, and management. It then describes how acute rheumatic fever is an autoimmune response to Group A streptococcal infection that causes inflammation in multiple organs. The Jones criteria are used for diagnosis and require certain major or minor clinical features. Management involves treating underlying streptococcal infections and suppressing inflammation. Primary prevention focuses on proper treatment of streptococcal pharyngitis to prevent recurrent rheumatic fever.
Rheumatic heart disease is caused by rheumatic fever, which results from a streptococcal throat infection. It often affects children in developing countries. Rheumatic fever causes inflammation that damages the heart valves over time, leading to permanent valve problems. The mitral valve is most often affected, resulting in complications like murmurs, cardiomegaly, and cardiac failure. Diagnosis involves assessing for symptoms of previous streptococcal infection and valvular damage, along with lab tests and echocardiogram. Treatment focuses on antibiotics to prevent future infections from triggering relapses, as well as medications and potentially surgery to address valvular problems.
Rheumatic heart disease is a chronic condition caused by rheumatic fever, which is triggered by an autoimmune reaction to a group A streptococcal infection. It most commonly affects the mitral valve, causing inflammation and scarring that can lead to valvular problems like stenosis or regurgitation. In developing countries, rheumatic heart disease remains a major public health problem, with over 15 million cases worldwide resulting in over 200,000 deaths annually. Treatment involves antibiotics to treat the initial strep infection along with medications and potentially surgery to address valvular damage.
Acute Rheumatic Fever is a multisystem inflammatory disorder that occurs as a delayed immune response following a streptococcal throat infection. It primarily involves the heart, joints, brain, skin and tissues. It is more common in children ages 5-15 from low socioeconomic backgrounds with poor living conditions. The pathogenesis involves molecular mimicry between antigens in the streptococcus bacteria and human tissues, leading to cross-reactivity and tissue damage. Diagnosis is based on clinical features meeting the revised Jones criteria along with evidence of a prior streptococcal infection. Treatment involves bed rest, antibiotics, salicylates and possibly steroids. Secondary prevention with long-term antibiotics aims to prevent recurrent attacks and heart damage.
Rheumatic fever is a sequel to group A streptococcal infection, usually of the throat. It causes chronic damage to the heart valves. The Jones criteria are used to diagnose it based on major manifestations like carditis or migratory polyarthritis, and minor criteria like fever or arthritis. Treatment involves antibiotics for the streptococcal infection, aspirin or steroids for inflammation, and lifelong antibiotic prophylaxis to prevent recurrence and further heart damage. Preventing initial streptococcal infections is key to reducing rheumatic fever incidence.
Group A strep can cause pharyngitis, which in rare cases can lead to acute rheumatic fever and rheumatic heart disease. Rheumatic fever is an autoimmune response following a strep throat infection, causing inflammation in joints, heart valves, and other tissues. It affects children primarily in developing countries. Prompt diagnosis and treatment of strep throat is key to preventing rheumatic fever. Rheumatic heart disease is permanent heart damage from repeated rheumatic fever attacks and is the most severe consequence, with symptoms depending on the valves affected. Control programs aim to prevent rheumatic fever through strep throat screening, treatment and public awareness.
Acute rheumatic fever is an autoimmune disease that can occur after a streptococcal throat infection. It commonly affects children ages 5-15 and involves the heart, joints, skin, and brain. Joint pain and heart valve damage are among the main clinical manifestations. Diagnosis is based on the Jones criteria of symptoms and a prior streptococcal infection. Treatment involves antibiotics to eliminate the bacteria, anti-inflammatory drugs like aspirin to reduce symptoms, and long-term antibiotic prophylaxis to prevent recurrence of the disease from future streptococcal infections. Those with carditis have a risk of developing rheumatic heart disease.
- Acute rheumatic fever is an autoimmune disease that develops after a streptococcal infection. It can cause inflammation in joints, heart valves, brain, and skin.
- The document discusses the etiology, pathogenesis, clinical features, and management of acute rheumatic fever. It is caused by an immune reaction to a streptococcal infection that results in cross-reactivity with human tissues. Common symptoms include polyarthritis, carditis, chorea, and erythema marginatum.
- Diagnosis involves confirming a preceding streptococcal infection through elevated antibody titers as well as evidence of systemic inflammation from tests like ESR and CRP. Echocardiography and ECG can
Infective endocarditis by Dr. Basil Tumaini and Dr. Shamsherali EbrahimBasil Tumaini
Infective endocarditis is an infection of the heart valves or endocardium. It can involve one or more valves or the inner lining of the heart. This document provides definitions and classifications of infective endocarditis and discusses its epidemiology, microbiology, pathophysiology, clinical features, diagnosis, and treatment. Treatment involves antimicrobial therapy targeting the likely causative pathogens, with combinations of drugs preferred over monotherapy to achieve bactericidal concentrations and potentially shorten treatment duration. Surgery may also be required to treat sequelae of intracardiac lesions.
This document provides an overview of acute rheumatic fever presented by Dr. Renesha Islam. Some key points:
- Acute rheumatic fever is an immune response to Group A streptococcus infection that causes inflammation of the heart, joints, brain and skin. It often damages the heart valves long term.
- Major symptoms include migratory polyarthritis in joints (75% of cases), carditis (50-60% of cases, involving the heart valves, myocardium and pericardium), Sydenham's chorea (10-15% of cases), erythema marginatum and subcutaneous nodules (rare).
- Diagnosis is based on the revised Jones criteria
Rheumatic fever is an autoimmune condition that occurs after a Group A streptococcal infection, typically affecting the heart, joints, and brain. It causes inflammation of the heart valves, which can lead to scarring and deformity known as rheumatic heart disease. Symptoms of rheumatic heart disease include shortness of breath, palpitations, and swelling from fluid buildup. Treatment involves antibiotics to prevent initial and recurrent streptococcal infections, along with medications, surgery, and lifestyle changes to manage valve damage and heart failure. Complications can include arrhythmias, valve stenosis, heart failure, and endocarditis if left untreated.
Rheumatic fever is an autoimmune condition that occurs after a Group A streptococcal infection, typically affecting the heart, joints, and brain. It causes inflammation of the heart valves, which can lead to scarring and deformity known as rheumatic heart disease. Symptoms of rheumatic heart disease include shortness of breath, palpitations, and swelling from fluid buildup. Treatment involves antibiotics to prevent initial and recurrent streptococcal infections, along with medications, surgery, and lifestyle changes to manage valve damage and heart failure. Complications can include arrhythmias, valve stenosis, heart failure, and endocarditis if left untreated.
1. Acute rheumatic fever is an autoimmune disease that develops after a streptococcal infection and can affect the heart, joints, brain and skin. It is mainly seen in children aged 5-14 years from low socioeconomic backgrounds.
2. Bronchiectasis is a chronic lung condition caused by persistent lung infections that destroys the airways and causes them to dilate permanently. It can result from cystic fibrosis, primary ciliary dyskinesia or severe lung infections and treatments involve airway clearance and long-term antibiotics.
3. Both conditions involve recurrent infections and inflammation of the lungs and/or heart but acute rheumatic fever is self-limiting while bronchiectasis is
Acute rheumatic fever is an inflammatory disease that can develop following a streptococcal infection such as strep throat or scarlet fever. It primarily affects the heart, joints, brain, and skin. Common symptoms include fever, joint pain, abnormal heart rhythms, involuntary movements, and rashes. It is most common in children ages 5-15. Treatment involves antibiotics to treat the initial infection, medications to reduce inflammation and symptoms, and long-term preventative antibiotics to avoid recurrence. Nursing care focuses on reducing fever, monitoring for cardiac complications, maintaining activity and rest, and educating patients and families.
Rheumatic fever is an inflammatory disease that can occur after a streptococcal throat infection and cause permanent heart damage known as rheumatic heart disease. Rheumatic heart disease involves valve damage, usually to the mitral valve, which initially causes regurgitation and later stenosis. Infective endocarditis is a bacterial infection of the heart valves or inner lining of the heart. It commonly involves the formation of vegetations on the valves. Diagnosis involves blood cultures and echocardiography. Treatment consists of prolonged intravenous antibiotics targeting the specific bacterium along with surgery in some severe cases. Prophylactic antibiotics are recommended for at-risk patients undergoing certain medical procedures to prevent transient bacteremias from causing infective
This document discusses rheumatic heart disease, which is a chronic condition that develops due to damage caused by acute rheumatic fever during childhood. Rheumatic fever is an inflammatory disease that occurs after a streptococcal throat infection and can cause long-term heart valve problems and scarring referred to as rheumatic heart disease. It most often affects the mitral valve and is characterized by narrowed or leaky valves. Treatment involves antibiotics to prevent recurrence, as well as medications and potentially surgery to address heart failure and valve abnormalities.
1) Rheumatic fever is an autoimmune disease that can occur as a delayed complication of untreated Group A streptococcal pharyngitis, with a latent period of 1-3 weeks.
2) It commonly affects children between 5-15 years of age and can involve the heart, joints, skin, and brain. The heart is involved in approximately 50-60% of cases (carditis).
3) Treatment involves bed rest, antibiotics to eradicate streptococci, anti-inflammatory drugs like aspirin for arthritis and carditis, corticosteroids for moderate to severe carditis, and long-term antibiotic prophylaxis to prevent recurrences.
Rheumatic fever is an inflammatory disease that affects the heart and joints and is caused by a prior streptococcal infection. It occurs most often in children ages 5-15. The document outlines the pathogenesis of rheumatic fever including the role of streptococcal toxins and antigens. It also describes the clinical manifestations such as carditis, arthritis, chorea, and subcutaneous nodules. Diagnosis involves assessing symptoms and lab/imaging findings in the context of a prior streptococcal infection. Treatment involves antibiotics to treat strep infections as well as medications for symptoms and long-term prophylaxis with penicillin.
This document discusses rheumatic fever, including its etiology, pathogenesis, clinical manifestations, diagnosis, treatment, prevention, and prognosis. Rheumatic fever is caused by an autoimmune reaction following a Group A streptococcal throat infection. It affects the heart, joints, brain, and skin. Diagnosis is based on clinical criteria including arthritis, heart involvement, chorea, and evidence of a prior streptococcal infection. Treatment involves bed rest, antibiotics to eradicate the infection, and anti-inflammatory drugs. Recurrences can be prevented with long-term antibiotic prophylaxis. Prognosis depends on the degree of cardiac damage, which can sometimes resolve but worsens with repeated episodes.
Rheumatic fever is an inflammatory disease that affects the heart, joints, skin, and brain. It occurs as a result of a prior streptococcal throat infection. The body mounts an immune response against the bacteria that cross-reacts with human tissues, causing damage. Common manifestations include painful migratory arthritis, inflammation of the heart valves, and involuntary movements known as Sydenham's chorea. Rheumatic fever predominantly affects children in developing countries and can lead to the chronic rheumatic heart disease if heart valves are damaged. Diagnosis is based on clinical criteria and evidence of a preceding streptococcal infection.
This document discusses acute rheumatic fever and rheumatic heart disease. It begins by outlining the objectives of understanding the epidemiology, pathogenesis, clinical features, laboratory studies, and management. It then describes how acute rheumatic fever is an autoimmune response to Group A streptococcal infection that causes inflammation in multiple organs. The Jones criteria are used for diagnosis and require certain major or minor clinical features. Management involves treating underlying streptococcal infections and suppressing inflammation. Primary prevention focuses on proper treatment of streptococcal pharyngitis to prevent recurrent rheumatic fever.
Rheumatic heart disease is caused by rheumatic fever, which results from a streptococcal throat infection. It often affects children in developing countries. Rheumatic fever causes inflammation that damages the heart valves over time, leading to permanent valve problems. The mitral valve is most often affected, resulting in complications like murmurs, cardiomegaly, and cardiac failure. Diagnosis involves assessing for symptoms of previous streptococcal infection and valvular damage, along with lab tests and echocardiogram. Treatment focuses on antibiotics to prevent future infections from triggering relapses, as well as medications and potentially surgery to address valvular problems.
Rheumatic heart disease is a chronic condition caused by rheumatic fever, which is triggered by an autoimmune reaction to a group A streptococcal infection. It most commonly affects the mitral valve, causing inflammation and scarring that can lead to valvular problems like stenosis or regurgitation. In developing countries, rheumatic heart disease remains a major public health problem, with over 15 million cases worldwide resulting in over 200,000 deaths annually. Treatment involves antibiotics to treat the initial strep infection along with medications and potentially surgery to address valvular damage.
Acute Rheumatic Fever is a multisystem inflammatory disorder that occurs as a delayed immune response following a streptococcal throat infection. It primarily involves the heart, joints, brain, skin and tissues. It is more common in children ages 5-15 from low socioeconomic backgrounds with poor living conditions. The pathogenesis involves molecular mimicry between antigens in the streptococcus bacteria and human tissues, leading to cross-reactivity and tissue damage. Diagnosis is based on clinical features meeting the revised Jones criteria along with evidence of a prior streptococcal infection. Treatment involves bed rest, antibiotics, salicylates and possibly steroids. Secondary prevention with long-term antibiotics aims to prevent recurrent attacks and heart damage.
Rheumatic fever is a sequel to group A streptococcal infection, usually of the throat. It causes chronic damage to the heart valves. The Jones criteria are used to diagnose it based on major manifestations like carditis or migratory polyarthritis, and minor criteria like fever or arthritis. Treatment involves antibiotics for the streptococcal infection, aspirin or steroids for inflammation, and lifelong antibiotic prophylaxis to prevent recurrence and further heart damage. Preventing initial streptococcal infections is key to reducing rheumatic fever incidence.
Group A strep can cause pharyngitis, which in rare cases can lead to acute rheumatic fever and rheumatic heart disease. Rheumatic fever is an autoimmune response following a strep throat infection, causing inflammation in joints, heart valves, and other tissues. It affects children primarily in developing countries. Prompt diagnosis and treatment of strep throat is key to preventing rheumatic fever. Rheumatic heart disease is permanent heart damage from repeated rheumatic fever attacks and is the most severe consequence, with symptoms depending on the valves affected. Control programs aim to prevent rheumatic fever through strep throat screening, treatment and public awareness.
Acute rheumatic fever is an autoimmune disease that can occur after a streptococcal throat infection. It commonly affects children ages 5-15 and involves the heart, joints, skin, and brain. Joint pain and heart valve damage are among the main clinical manifestations. Diagnosis is based on the Jones criteria of symptoms and a prior streptococcal infection. Treatment involves antibiotics to eliminate the bacteria, anti-inflammatory drugs like aspirin to reduce symptoms, and long-term antibiotic prophylaxis to prevent recurrence of the disease from future streptococcal infections. Those with carditis have a risk of developing rheumatic heart disease.
- Acute rheumatic fever is an autoimmune disease that develops after a streptococcal infection. It can cause inflammation in joints, heart valves, brain, and skin.
- The document discusses the etiology, pathogenesis, clinical features, and management of acute rheumatic fever. It is caused by an immune reaction to a streptococcal infection that results in cross-reactivity with human tissues. Common symptoms include polyarthritis, carditis, chorea, and erythema marginatum.
- Diagnosis involves confirming a preceding streptococcal infection through elevated antibody titers as well as evidence of systemic inflammation from tests like ESR and CRP. Echocardiography and ECG can
Infective endocarditis by Dr. Basil Tumaini and Dr. Shamsherali EbrahimBasil Tumaini
Infective endocarditis is an infection of the heart valves or endocardium. It can involve one or more valves or the inner lining of the heart. This document provides definitions and classifications of infective endocarditis and discusses its epidemiology, microbiology, pathophysiology, clinical features, diagnosis, and treatment. Treatment involves antimicrobial therapy targeting the likely causative pathogens, with combinations of drugs preferred over monotherapy to achieve bactericidal concentrations and potentially shorten treatment duration. Surgery may also be required to treat sequelae of intracardiac lesions.
This document provides an overview of acute rheumatic fever presented by Dr. Renesha Islam. Some key points:
- Acute rheumatic fever is an immune response to Group A streptococcus infection that causes inflammation of the heart, joints, brain and skin. It often damages the heart valves long term.
- Major symptoms include migratory polyarthritis in joints (75% of cases), carditis (50-60% of cases, involving the heart valves, myocardium and pericardium), Sydenham's chorea (10-15% of cases), erythema marginatum and subcutaneous nodules (rare).
- Diagnosis is based on the revised Jones criteria
Rheumatic fever is an autoimmune condition that occurs after a Group A streptococcal infection, typically affecting the heart, joints, and brain. It causes inflammation of the heart valves, which can lead to scarring and deformity known as rheumatic heart disease. Symptoms of rheumatic heart disease include shortness of breath, palpitations, and swelling from fluid buildup. Treatment involves antibiotics to prevent initial and recurrent streptococcal infections, along with medications, surgery, and lifestyle changes to manage valve damage and heart failure. Complications can include arrhythmias, valve stenosis, heart failure, and endocarditis if left untreated.
Rheumatic fever is an autoimmune condition that occurs after a Group A streptococcal infection, typically affecting the heart, joints, and brain. It causes inflammation of the heart valves, which can lead to scarring and deformity known as rheumatic heart disease. Symptoms of rheumatic heart disease include shortness of breath, palpitations, and swelling from fluid buildup. Treatment involves antibiotics to prevent initial and recurrent streptococcal infections, along with medications, surgery, and lifestyle changes to manage valve damage and heart failure. Complications can include arrhythmias, valve stenosis, heart failure, and endocarditis if left untreated.
1. Acute rheumatic fever is an autoimmune disease that develops after a streptococcal infection and can affect the heart, joints, brain and skin. It is mainly seen in children aged 5-14 years from low socioeconomic backgrounds.
2. Bronchiectasis is a chronic lung condition caused by persistent lung infections that destroys the airways and causes them to dilate permanently. It can result from cystic fibrosis, primary ciliary dyskinesia or severe lung infections and treatments involve airway clearance and long-term antibiotics.
3. Both conditions involve recurrent infections and inflammation of the lungs and/or heart but acute rheumatic fever is self-limiting while bronchiectasis is
Acute rheumatic fever is an inflammatory disease that can develop following a streptococcal infection such as strep throat or scarlet fever. It primarily affects the heart, joints, brain, and skin. Common symptoms include fever, joint pain, abnormal heart rhythms, involuntary movements, and rashes. It is most common in children ages 5-15. Treatment involves antibiotics to treat the initial infection, medications to reduce inflammation and symptoms, and long-term preventative antibiotics to avoid recurrence. Nursing care focuses on reducing fever, monitoring for cardiac complications, maintaining activity and rest, and educating patients and families.
Rheumatic fever is an inflammatory disease that can occur after a streptococcal throat infection and cause permanent heart damage known as rheumatic heart disease. Rheumatic heart disease involves valve damage, usually to the mitral valve, which initially causes regurgitation and later stenosis. Infective endocarditis is a bacterial infection of the heart valves or inner lining of the heart. It commonly involves the formation of vegetations on the valves. Diagnosis involves blood cultures and echocardiography. Treatment consists of prolonged intravenous antibiotics targeting the specific bacterium along with surgery in some severe cases. Prophylactic antibiotics are recommended for at-risk patients undergoing certain medical procedures to prevent transient bacteremias from causing infective
This document discusses rheumatic heart disease, which is a chronic condition that develops due to damage caused by acute rheumatic fever during childhood. Rheumatic fever is an inflammatory disease that occurs after a streptococcal throat infection and can cause long-term heart valve problems and scarring referred to as rheumatic heart disease. It most often affects the mitral valve and is characterized by narrowed or leaky valves. Treatment involves antibiotics to prevent recurrence, as well as medications and potentially surgery to address heart failure and valve abnormalities.
1) Rheumatic fever is an autoimmune disease that can occur as a delayed complication of untreated Group A streptococcal pharyngitis, with a latent period of 1-3 weeks.
2) It commonly affects children between 5-15 years of age and can involve the heart, joints, skin, and brain. The heart is involved in approximately 50-60% of cases (carditis).
3) Treatment involves bed rest, antibiotics to eradicate streptococci, anti-inflammatory drugs like aspirin for arthritis and carditis, corticosteroids for moderate to severe carditis, and long-term antibiotic prophylaxis to prevent recurrences.
Rheumatic fever is an inflammatory disease that affects the heart and joints and is caused by a prior streptococcal infection. It occurs most often in children ages 5-15. The document outlines the pathogenesis of rheumatic fever including the role of streptococcal toxins and antigens. It also describes the clinical manifestations such as carditis, arthritis, chorea, and subcutaneous nodules. Diagnosis involves assessing symptoms and lab/imaging findings in the context of a prior streptococcal infection. Treatment involves antibiotics to treat strep infections as well as medications for symptoms and long-term prophylaxis with penicillin.
This document discusses rheumatic fever, including its etiology, pathogenesis, clinical manifestations, diagnosis, treatment, prevention, and prognosis. Rheumatic fever is caused by an autoimmune reaction following a Group A streptococcal throat infection. It affects the heart, joints, brain, and skin. Diagnosis is based on clinical criteria including arthritis, heart involvement, chorea, and evidence of a prior streptococcal infection. Treatment involves bed rest, antibiotics to eradicate the infection, and anti-inflammatory drugs. Recurrences can be prevented with long-term antibiotic prophylaxis. Prognosis depends on the degree of cardiac damage, which can sometimes resolve but worsens with repeated episodes.
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Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
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1. Update of Rheumatic Fever :
Prevention and Treatment
Teddy Ontoseno
Cardiology Division
Department of Child Health Dr Sutomo Hospital
Airlangga University
3. Rheumatic fever-pathogenesis
•Group A streptococcal(GAS) pharyngeal infection
•Body produce antibodies against streptococci ->
•These antibodies cross react with human tissues
because of the antigenic similarity between
streptococcal components and human connective tissues
(molecular mimicry)[there is certain amino acid sequence that
is similar btw GAS and human tissue]->
•Immunologically mediated inflamation & damage
(autoimmune) to human tissues which have antigenic
similarity with streptococcal components- like heart,
joint, brain connective tissues
6. Philosophical - Practical considerations
“Rheumatic fever”
• Immunologically mediated inflammatory
• Major public health problem
• Preventable and easily treatable
• Causing severe cardiac dysfuction
decades later
10. Rheumatic fever-epidemiology
• Parallels with epidemiology of streptococcal
pharyngitis(only when there is GAS throat infection,
there R.F.)
• Incidence –
• 3% in epidemics of exudative streptococcal
pharyngitis in closed community(school,army)
• 0.3% in civilian population with sporadic
streptococcal throat infection
• 50% if there is a past history of rheumatic
fever(thus secondary prophylaxis is important)
• first attack between 5-15 years(a childhood disease)
• poor socioeconomic conditions and overcrowding
11. Epidemiology
• Ages 5-15 yrs are most susceptible
• Rare < 3 yrs
• Girls > boys
• Common in 3rd world countries
• Environmental factors : over
crowding, poor sanitation, poverty
• Incidence more during fall ,winter &
early spring
12. EPIDEMIOLOGY
• Infection of the skin - younger than 6 yr
• Streptococcal pharyngitis - between 5
and 15 yr of age
• Scarlet fever - common in children > 3 yr
of age
17. Capsule
Cell wall
Protein antigens
Group carbohydrate
Peptidoglycan
Cyto.membrane
Cytoplasm
Antigen of outer
protein cell wall of
GABHS induces
antibody response in
victim which result
in autoimmune
damage to heart
valves, sub
cutaneous tissue,
tendons, joints &
basal ganglia of
brain
ETIOLOGY
19. AETHIOPATHOGENESIS
C. Anti-M antibodies against the streptococci
may cross-react with heart tissue, causing the
pancarditis that is observed in RF.
B. Rheumatogenic strains of
GABHS M types l, 3, 5, 6,18
& 24 have antigenic domains
similar to antigens in
components of the human heart
A. Only infections
GABHS of the pharynx
initiate or reactivate
RF.
22. Molecular mimicry is one way in which infectious agents can break self-
tolerance. An immune response to bacterial antigens with similarities to
self tissue antigens can lead to an autoimmune reaction against the self
tissue
24. Clinical Features:
• R.F. can be presented in many ways:
a. arthritis without cardiac involvement
b. rheumatic chorea without arthritis nor carditis
c. carditis with or without arthritis
29. The Jones Criteria for Rheumatic
Fever, Updated 1992
• Major Criteria
– Carditis
– Migratory polyarthritis
– Sydenham's chore
– Subcutaneous nodules
– Erythema marginatum
•Minor Criteria
– Clinical
• fever
• Arthralgia
– Laboratory
• Elevated acute phase
reactants
• Prolonged PR interval
plus
Supporting evidence of a recent group A streptococcal infection
• positive throat culture or
• rapid antigen detection test; and/ or elevated or
• increasing streptococcal antibody test
(e.g., anti-streptolysin O, anti-deoxyribonuclease B, anti-hyaluronidase).
30.
31. Major criteria of Jones
Help to remember :
CAPOCHES
Carditis
Polyarthritis
Chorea
Erythema Marginatum
Subcutan nodule
32. Carditis of ARF
• Pancarditis
• 40 and 60% of patients with ARF
• Characterised by
– sinus tachycardia,
–Organic cardiac murmurs not previously
present (mitral regurgitation)
– pericardial friction rub
– cardiomegaly
– prolonged PR interval and evidence of heart failure
may be present – nonspecific
33. Carditis
• Course : mild – fulminant
• Onset : first 3 weeks of illness
• Cardiac enzymes: normal or
minimally elevated
34. Subcutaneous nodules
• Rarely seen and when
present
• Usually associated with
severe carditis.
• Painless, firm, movable,
measuring around 0.5 to
2 cm.
• Located over extensor
surfaces of the joints,
particularly knees, wrists
and elbows
42. Mitral regurgitation
• Apical blowing holosystolic murmur
Pure rheumatic MR
due to shortening of
valve cusps and of
papillary muscles
chordae tendineae
that become matted
and adherent to the
valve.
43. Chronic RHD:
• Valve leaflet
thickening.
• Shortening,
thickening and
fusion of
tendinous cords.
44. Mitral Stenosis
• Apical diastolic rumbling murmur
• Almost always caused by previous
rheumatic fever
• Rheumatic fever cause
– *a chronic process of valvular
fibrosis
– *commissures are fused
– * the cusps are severely thickened
– *calcification with shortened,
thickened chordae tendineae
45.
46. Laboratory Investigations:
No specific laboratory investigations
I. Acute phase reactant
(CRP, SAA, SAP, Complements, Coagulation
Proteins)
2. Serologis and bacteriologis (ASO, Anti-
DNAse B titres, Culture)
3. Electrocardiography, radiology,
echocardiograpphy
49. Echocardiogram
• Valvular nodules or thickening
on body or tip of leaflets
• Annular dilatation
• Elongated chordae to the
anterior leaflet with
posterolateral jet
• Low cardiac output
• Pericardial effusion
52. Differential diagnosis of
rheumatic fever
• Rheumatic fever and rheumatoid arthritis are completely
different diseases although both are immmunologically
mediated diseases.
• But remmember R.F. is more serious and more important as it
can be prevented.
53. Treatment
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.
54. Treatment
• Another important cornerstone in treating
rheumatic fever includes the continuous
use of low dose antibiotics (such as
penicillin, sulfadiazine, or erythromycin)
to prevent recurrence.
55. Plan Of Action
• Step 0 : Primordial prevention
• Step I : Primary prevention
(eradication of streptococci)
• Step II : anti inflammatory treatment
(aspirin,steroids)
• Step III : supportive management &
management of complications
• Step IV : Secondary prevention
(prevention of recurrent attacks)
56. Plan of Action
Step o : Primordial prevention
Pharyngitis GABHS strain 1,3,5,6,18,24
Step I : Primary prevention
Latent periode
Rheumatic Fever (by Jones criteria)
Step II : Anti inflammation
Step III : supportive and complications management
Step IV : Secondary prevention
Carditis + Carditis –
(Mur-mur,Pericarditis,Tacycardia)
Mild Mod Severe
Cardiomegali - + +
MR gr 2 >2 >2
CHF - - -
57. Step 0: Primordial Prevention
• Primordial prevention of the disease
– Immunization (?)
– Socio economic
– Nutrition
– Public education (school going age, parents,
teachers, all personil involve with children, etc)
• Control spread of disease to others
– Reduce risk of cross-transmission of organisms
– Infection control policies
– Handwashing
– Overcrowding
– Availability to prompt medical care
58. STEP I: Primary Prevention of
Rheumatic Fever
• The most important way to prevent
rheumatic fever is by proper and
prompt treatment of strep throat and
scarlet fever (eradication of GABHS)
59. Treatment of Streptococcal
Pharyngitis
• Objective of therapy
–Eliminate streptococci from the
pharynx
–Prevent rheumatic fever
–Prevent suppurative
complications
–Hasten clinical recovery
60. Treatment of Streptococcal
Pharyngitis
• Penicillin - drug of choice
–One intramuscular injection of
long acting penicillin
(benzathine) or oral therapy for
10 days
–No significant penicillin
resistance
• Erythromycin - if penicillin allergic
61. STEP I: Primary Prevention of Rheumatic Fever
(Treatment of GABHS Tonsillopharyngitis)
Agent Dose Mode Duration
Benzathine penicillin G 600 000 U for patients Intramuscular Once
27 kg (60 lb)
1 200 000 U for patients >27 kg
or
Penicillin V Children: 250 mg 2-3 times daily Oral 10 d
(phenoxymethyl penicillin) Adolescents and adults:
500 mg 2-3 times daily
For individuals allergic to penicillin
Erythromycin: 20-40 mg/kg/d 2-4 times daily Oral 10 d Estolate
(maximum 1 g/d)
or
Ethylsuccinate 40 mg/kg/d 2-4 times daily Oral 10 d
(maximum 1 g/d)
Recommendations of American Heart Association
62.
63.
64.
65.
66.
67. Arthritis only Aspirin 75-100
mg/kg/day,give as 4
divided doses for 6
weeks
(Attain a blood level 20-
30 mg/dl)
Carditis Prednisolone 2-2.5
mg/kg/day, give as two
divided doses for 2
weeks
Taper over 2 weeks &
while tapering add
Aspirin 75 mg/kg/day
for 2 weeks.
Continue aspirin alone
100 mg/kg/day for
another 4 weeks
Step II: Anti inflammatory treatment
Clinical condition Drugs
68. • Bed rest
• Treatment of congestive cardiac failure:
-digitalis,diuretics
• Treatment of chorea:
-diazepam or haloperidol
• Rest to joints & supportive splinting
Supportive & management of
complications
Step III
69. STEP IV : Secondary Prevention of Rheumatic Fever
(Prevention of Recurrent Attacks)
Agent Dose Mode
Benzathine penicillin G 1 200 000 U every 4 weeks* Intramuscular
or
Penicillin V 250 mg twice daily Oral
or
Sulfadiazine 0.5 g once daily for patients 27 kg (60 lb Oral
1.0 g once daily for patients >27 kg (60 lb)
For individuals allergic to penicillin and sulfadiazine
Erythromycin 250 mg twice daily Oral
*In high-risk situations, administration every 3 weeks is justified and
recommended
Recommendations of American Heart Association
70. Duration of Secondary Rheumatic Fever
Prophylaxis
Category Duration
Rheumatic fever with carditis and At least 10 y since last
residual heart disease episode and at least until
(persistent valvar disease*) age 40 y, sometimes lifelong
prophylaxis
Rheumatic fever with carditis 10 y or well into adulthood,
but no residual heart disease whichever is longer
(no valvar disease*)
Rheumatic fever without carditis 5 y or until age 21 y,
whichever is longer
*Clinical or echocardiographic evidence.
Recommendations of American Heart Association
71. The roles for antibiotics in Rheumatic
Fever
• (1) initially treat GABHS pharyngitis
• (2) prevent recurrent streptococcal
pharyngitis, RF, and RHD
• (3) provide prophylaxis against bacterial
endocarditis.
72. Prevent bacterial endocarditis
• Patients who had RF without valve damage do
not need endocarditis prophylaxis.
• Do not use penicillin, ampicillin, or amoxicillin
for endocarditis prophylaxis in patients already
receiving penicillin for secondary RF
prophylaxis (relative resistance of oral
streptococci to penicillin and aminopenicillins).
73. Prevent bacterial endocarditis
• Alternate drugs recommended by the
American Heart Association for these
patients include oral clindamycin
(children: 20 mg/kg; adults: 600 mg) and
oral azithromycin or clarithromycin
(children: 15 mg/kg; adults: 500 mg)
74. Antibiotic prophylaxis
o Finally, patients with RF with
carditis and valve disease should
receive antibiotics at least 10
years or until aged 40 years.
75. Therapy for congestive heart failure
• Heart failure in RHD probably is related in
part to severe insufficiency of the mitral and
aortic valves and in part to pancarditis.
• Traditionally : inotropic agent (digitalis) in
combination with diuretics (furosemide,
spironolactone) and afterload reduction
(vasodilating Ca blockers, hydralazine, ACE inhibitors, or
nitrates).
76. Surgical vs Non Surgical Care:
• Surgery for patients who remain symptomatic
despite medical management.
• Critical MS requiring valvotomy or valve
replacement is associated with an oval orifice
<= 1.75 × 0.85 cm.
–balloon valvuloplasty
–open valvotomy and valvuloplasty can be
done.
–valve replacement is necessary
77. Diet:
• Without restrictions except in patients
with CHF, who should follow a fluid-
restricted and sodium-restricted diet.
• Potassium supplementation may be
necessary because of the
mineralocorticoid effect of corticosteroid
and the diuretics, if used.
78. Activity:
Initially, on bed rest, followed by a period of
indoor activity before they are permitted to
return to school.
Do not allow full activity until the APRs have
returned to normal.
Patients with chorea may require a
wheelchair and should be on homebound
instruction until the abnormal movements
resolve.
80. Patient Education:
–Timely evaluation and treatment of
pharyngitis in children.
–Secondary prophylaxis of patients with
previous RF and valve involvement with
penicillin injections every 3-4 weeks
decrease the recurrence of RHD.
–Additional prophylactic antibiotics prior to
dental and surgical procedures.
81. Rheumatic Fever - Prognosis
• Is good if recurrence is prevented by
continuous antibiotic prophylaxis- particularly if
no carditis in the initial attack
• Can recur whenever the individual experience
new GABH streptococcal infection,if not on
prophylactic medicines
• Good prognosis for older age group & if no
carditis during the initial attack
• Bad prognosis for younger children & those
with carditis with valvar lesions