Rheumatic fever
Description
Systemic inflammatory disease of childhood that occurs 2 to 6 weeks after an inadequately treated upper respiratory infection with group A beta-hemolytic streptococci
Principally involves the heart, joints, central nervous system, skin, and subcutaneous tissues
Commonly recurs
Pathophysiology
Rheumatic fever is a hypersensitivity reaction to a group A beta-hemolytic streptococcal infection, in which antibodies are manufactured to prevent streptococci from reacting and producing characteristic lesions at specific tissue sites, especially in the heart and joints.
Antigens of group A streptococci bind to receptors in the heart, muscle, brain, and synovial joints, causing an autoimmune response.
Rheumatic heart disease refers to cardiac manifestations of rheumatic fever (pancarditis [myocarditis, pericarditis, and endocarditis] during the early acute phase and chronic valvular disease later).
AlertIn children, mitral insufficiency is the major consequence of rheumatic heart disease.
Causes
Prior group A beta-hemolytic streptococcal infection
Assessment findings
The Jones criteria for diagnosing rheumatic fever (the patient must have two major criteria or one major and two minor criteria):
Major criteria:
