Rheumatic Fever in Children
Rheumatic fever is a delayed sequela of streptococcal infections in children, primarily affecting ages 6-15. It presents with symptoms like heart murmurs, arthritis, involuntary movements, fever, and rash. Diagnosis involves evidence of a recent streptococcal infection, ASO titers, and physical manifestations such as joint pain, carditis, subcutaneous nodules, and chorea. Treatment typically includes penicillin, salicylates, rest, and supportive care for associated conditions.
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Presentation Transcript
Rheumatic Fever Dr.Zahra Hosseini nezhad ,Pediatric Neurologist
delayed sequela of group A beta-hemolytic streptococcal infections of the pharynx 6-15 years of age immunological reaction FH+_
Heart Murmurs Arthritis Involuntary Movements Fever and Rash
Infection Evidence of an antecedent streptococcal infection 2-6 weeks ago ASO titer
Arthritis most common major manifestation large joints migratory
Arthralgia cannot be used as a minor manifestation if arthritis is used as a major manifestation.
Carditis 50% Tachycardia a new murmur (mitral or aortic regurgitation) pericarditis Cardiomegaly signs of heart failure
Erythema marginatum nonpruritic evanescent rashis on the trunk brought out by warmth
Subcutaneous nodules In chronic or recurrent disease firm, painless, nonpruritic, mobile extensor surfaces of the large and small joints, the scalp, and the spine.
Chorea neurological and psychiatric Long after the infection
TREATMENT penicillin Salicylates bed rest supportive therapy for heart failure or chorea
Prophylaxis Long-term penicillin prophylaxis penicillin G, 1.2 million U every 28 days, is required
prognosis depends on the degree of permanent cardiac damage The severity of cardiac involvement worsens with each recurrence of rheumatic
