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Rheumatic Fever (Misc (Rare in developed countries (Incidence 0.3/1000),…
Rheumatic Fever
Misc
Rare in
developed countries
Incidence 0.3/1000
Important cause of heart disease in children Worldwide
Incidence of 6/1000 in Sub Saharan Africa
Multi system autoimmune response to group A
β-haemolytic streptococcus
Progresses to chronic disease in 80%
S+S
Latent interval of 2-6 week following pharyngeal or skin infection
Jones criteria for diagnosis
Two major
or
One major and two minor
Plus supporting evidence of preceding group A strep infection
Mx
Acute
Bed rest
Anti-inflammatories
Aspirin
High dose
Serum level moniotring
1st line
Steroids
2nd line
Exercise limitation
Management of heart failure
Valve replacement
Prophylaxis
Monthly IM
benzyl penicillin
Daily penicillin
Poor compliance
+less effective
Erythromycin if allergic
10 years or up to age 21 (whichever is longer)