Rheumatic Fever - GM

Question 1

what is rheumatic fever

Answer 1

systemic inflammatory disorder that arises as a complication following infection of group A strep
unlike the initial condition, rheumatic fever is not contagious

Question 2

epidemiology of rheumatic fever

Answer 2

children 5-15yo
girls affected slightly more than boys
rarely presents for the first time in adulthood
rheumatic fever may return later in life if left untreated
all patients who have a sore throat who have previously had rheumatic fever should seek medical advice

Question 3

pathophysiology

Answer 3

rheumatic fever develops between one to five weeks after initial infection with lancefeild group A beta-haemolytic streptococci (streptococcus pyogenes)
initial infection manifests as pharyngitis but may also present as cellulitis

Question 4

which people will develop rheumatic fever after strep infection

Answer 4

rheumatic fever develops in susceptibe hosts (about 2% of the population) due to a hypersensitivity reactiion against the bacteria
similarities in the molecular makeup of the call walls of strepptococcl bacteria and human heart valve tissue may result in the body’s antibodies erroneously attacking the host instead of the pathogen, leading to permanent damage to valves

Question 5

biological risk factors for developing rheumatic fever

Answer 5

rare in children under 4 years
more common in females
ethnicity: higher prevalence in indigenous populations
immune status
genetic susceptibility
prior or untreated infection with strep pyogenes
virulence of infeective organism

Question 6

social risk factors

Answer 6

low socioeconomic status
overcrowding and poor housing
climate: higher incidence over winter months, in hot countries strep infection is more likely to present as a skin infection than strep throat