E1: Rheumatic Fever

rheumatic fever

systemic immune process that is sequela of GABHS infection in pharynx

what evidence is required to diagnose rheumatic fever?

strep infection

rheumatic fever

systemic immune process that is sequela of GABHS infection in pharynx

what evidence is required to diagnose rheumatic fever?

strep infection

what ages are most affected by rheumatic fever?

5-15 y/o

What is the most common valve affected by rheumatic fever?

Mitral valve

when do signs of rheumatic fever appear?

2-3 weeks after infection

What are the Jones major criteria?

CCEPS

Carditis

Chorea

Erythema marginatum

Polyarthritis

SQ nodules

what is a positive result in Jone's criteria that establishes the diagnosis of rheumatic fever?

2 major or 1 major + 2 minor

what murmur is heard in carditis?

Carey-Combs short mid-diastolic mitral murmur

Involuntary movements primarily involving the face, tongue, and upper extremity

Chorea
(aka St. Vitus Dance)

Where is erythema marginatum commonly found?

Trunk and proximal extremities

what does erythema marginatum look like?

round margins with clear centers, lesions vary in size
- nonpuritic, nonindurated, blanch on pressure

Where are the subcutaneous nodules associated with rheumatic fever located?

Extensor tendons of hands and scalp
lesions are painless & non-tender

What is the most common murmur associated with acute rheumatic fever?

Mitral stenosis

Tx for acute rheumatic fever

Penicillin

Secondary prevention of ARF recurrences

Benzathine Pen G q4wks

prevention of ARF recurrences for PCN allergy

Cephalosporin or Macrolide (erythro or azithro)