Rheumatic fever

• Facts:
  Complication of group A Streptococcal pharyngitis (usually precedes RF by 2-4wks)
  
  Prevented by proper treatment of Streptococcal pharyngitis
  
  RH disease caused by antistreptococcal antibodies cross-reacting with a cardiac antigen ( type 2 hypersensitivity reaction )
• History / PE:
  Diagnosed clinically by using JONES criteria
• Diagnosis:
  Evidence of preceding strep infection, plus EITHER
  two major criteria or one major AND two minor criteria
  
  Elevated antistreptolysin antibodies (ASO), DNAse B
• Notes:
  MAJOR CRITERIA
  
  1) Carditis
  2) Sydenham chorea
  3) Migratory polyarthritis
  4) Subcutaneous nodules
  5) Erythema marginatum
  
  MINOR CRITERIA
  
  1) Arthralgia
  2) Fever
  3) Elevated ESR/C reactive protein
  4) Prolonged PR interval
• Associated With:
  Scarlet fever