Rheumatic Fever Treatment and Jones Criteria

Study Notes

Antibiotics: Penicillin or erythromycin are used to eliminate the streptococcal infection.
Anti-inflammatory medications: Aspirin, naproxen, or corticosteroids are used to reduce inflammation and relieve symptoms.
Bed rest: Rest is essential to reduce stress on the heart and joints.
Secondary prevention: Long-term antibiotics are used to prevent recurrence of rheumatic fever.

Major criteria:
1. Carditis (inflammation of the heart)
2. Migratory polyarthritis (inflammation of multiple joints)
3. Sydenham's chorea (involuntary movements)
4. Erythema marginatum (a characteristic rash)
5. Subcutaneous nodules (small, painless bumps under the skin)
Minor criteria:
1. Fever
2. Arthralgia (joint pain)
3. Elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)
4. Prolonged PR interval (electrocardiogram abnormality)

Rheumatic heart disease: The most common complication, leading to heart valve damage and potentially heart failure.
Chorea: Involuntary movements can be persistent and debilitating.
Arthritis: Joint inflammation can lead to chronic pain and disability.
Cardiac arrhythmias: Abnormal heart rhythms can occur due to heart damage.

Clinical evaluation: Medical history, physical examination, and laboratory tests are used to diagnose rheumatic fever.
Throat culture: A sample from the throat is taken to confirm the presence of group A streptococcus.
Blood tests: Elevated ASO (antistreptolysin O) or anti-DNase B titers indicate a recent streptococcal infection.
Electrocardiogram: Used to diagnose cardiac arrhythmias and conduction abnormalities.

Group A streptococcal infection: The initial infection triggers an immune response, leading to the production of cross-reactive antibodies.
Cross-reactivity: The antibodies mistakenly target the body's own tissues, including the heart, joints, and skin.
Inflammation: The immune response leads to inflammation and tissue damage in the affected organs.
Autoimmune response: The immune system continues to attack the body's own tissues, perpetuating the disease process.

Penicillin or erythromycin are used to eliminate streptococcal infection
Anti-inflammatory medications such as aspirin, naproxen, or corticosteroids are used to reduce inflammation and relieve symptoms
Bed rest is essential to reduce stress on the heart and joints
Long-term antibiotics are used for secondary prevention to prevent recurrence of rheumatic fever

Major criteria include: carditis, migratory polyarthritis, Sydenham's chorea, erythema marginatum, and subcutaneous nodules
Minor criteria include: fever, arthralgia, elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), and prolonged PR interval

Rheumatic heart disease is the most common complication, leading to heart valve damage and potentially heart failure
Chorea can be persistent and debilitating
Arthritis can lead to chronic pain and disability
Cardiac arrhythmias can occur due to heart damage

Clinical evaluation includes medical history, physical examination, and laboratory tests
Throat culture is used to confirm the presence of group A streptococcus
Blood tests including elevated ASO (antistreptolysin O) or anti-DNase B titers indicate a recent streptococcal infection
Electrocardiogram is used to diagnose cardiac arrhythmias and conduction abnormalities

Group A streptococcal infection triggers an immune response, leading to the production of cross-reactive antibodies
Cross-reactivity occurs when antibodies mistakenly target the body's own tissues, including the heart, joints, and skin
Inflammation leads to tissue damage in the affected organs
Autoimmune response perpetuates the disease process, as the immune system continues to attack the body's own tissues