Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Rheumatic Fever”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 973 records · Page 54Linked to original sources
PubMedDate not supplied

[Rheumatic fever from 1960's to 1990's. Case records in 2 hospitals of the Lombardian area].

An epidemiological study of rheumatic fever (RF) has been done. Incidence and prevalence of RF observed in Monza Hospital from 1964 to 1990 and in Como Hospital from 1980 to 1990 both show a progressive reduction. An exception to this trend was observed in 1986 in Monza in 1985 in Como. The percentage of carditis in pediatric age is high (60-70%), often associated with arthritis and chorea. However carditis clinical picture seems nowadays less severe, probably because in the past the diagnosis was delayed. Sice 1980 no death were observed due to RF or related cardiac involvement. Relapses and residual valvulopathies are significantly reduced only when penicillin prophylaxis was correctly performed.

Adolescent↗
PubMed1986

Detection of antibodies to muramyl dipeptide, the adjuvant moiety of streptococcal cell wall, in patients with rheumatic fever.

The presence of antibodies to muramyl dipeptide (MDP), an adjuvant structure of streptococcal peptidoglycan, was investigated in patients with acute rheumatic fever (ARF). The detection of these antibodies was done by an enzyme-linked immunosorbent assay with a synthetic multivalent MDP conjugate as an antigen. Sera from 33 of 54 children with ARF had detectable levels of antibodies to MDP at the time of diagnosis. Such antibodies could only be detected in sera from two of 52 healthy children and one of 21 children with acute poststreptococcal glomerulonephritis. The specificity of the antibodies to MDP was demonstrated by inhibition, with free MDP, of binding of the sera to the MDP conjugate. The possible use of these antibodies in the diagnosis of ARF and in screening for safe synthetic muramyl peptides in immunization of humans is discussed.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed2003

Rheumatic fever in children younger than 5 years: is the presentation different?

OBJECTIVE: To review our experience with children who presented with rheumatic fever (RF) before 5 years of age and to compare their presentation with that of older children. METHODS: The cardiology database was reviewed to identify patients who were younger than 5 years and had a diagnosis RF using the Jones criteria from January 1985 through March 2000. Patient age, sex, date and age at presentation, and the major Jones criteria fulfilled were noted. When carditis was present, its severity was judged to be moderate to severe when there was radiographic cardiomegaly and/or clinical congestive heart failure. The clinical presentation of patients who presented in the first 5 years of life were compared with the presentation of those whose RF was diagnosed after 5 years of age. Clinical findings at follow-up evaluation and echocardiographic findings both at presentation and at follow-up were noted for the children who were younger than 5 years at presentation. RESULTS: Of 541 cases of RF seen from January 1985 through March 20000, 27 (5%) were in children who were younger than 5 years (median: 4.0 years; range: 1.9-4.9 years). Major Jones criteria at presentation were arthritis in 17, carditis in 14, chorea in 3, and erythema marginatum in 3. The carditis was mild in 4 and moderate to severe in 10 patients. Compared with older children, younger children were more likely to present with moderate to severe carditis, arthritis without carditis or chorea, or the rash of erythema marginatum and were less likely to have chorea. The incidence of carditis was similar in the 2 groups as was the ratio of boys to girls. At follow-up (9.6 +/- 5.6 years), 69% of younger children who presented with carditis have clinical rheumatic heart disease. Subclinical, echocardiographically detected valvular abnormalities were detected both at presentation (33% of all children with RF before 5 years of age) and at follow-up (55% of those who initially had carditis). CONCLUSIONS: Approximately 5% of children with RF were younger than 5 years at diagnosis. Compared with older patients, children who presented before 5 years of age were more likely to have moderate to severe carditis and to present with arthritis or the rash of erythema marginatum and were less likely to have chorea. Chronic rheumatic heart disease was common in young children who presented with carditis. Long-term follow-up is necessary to determine the outcome for young children with subclinical echocardiographic evidence of valvular disease.

Child, Preschool↗
PubMed1978

Aortic valve replacement during acute rheumatic fever.

Emergency aortic valve replacement was performed during an attack of acute rheumatic fever in a 12-year-old black boy. He had an uneventful recovery and has remained asymptomatic 27 months after operation. In the light of this experience and that of others, one might conclude that the decision to operate on these patients should be based on the severity of the haemodynamic derangement rather than on the state of activity in the rheumatic process.

Acute Disease↗
PubMed2005

[Acute rheumatic fever (ARF) and poststreptococcal reactive arthritis (PSRA)--an update].

Betahemolytic strains of streptococcus A are able to induce a spectrum of immunologically induced diseases, depending on the immunogenic M structure of the bacteria as well as on the genetic determined reaction of the host. In acute rheumatic fever (ARF) the Jones criteria, revised and modified several times and updated in 1992, remain the diagnostic standard. Echocardiography, still not included in the Jones criteria, has become a very important diagnostic tool, especially as half of the ARF induced carditis cases are clinically inapparent. Diagnosis may be very difficult if arthritis is the only major sign, especially if not occurring in the typical migrating pattern, a fact frequently reported from countries with a high risk of ARF. Poststreptococcal reactive arthritis (PSRA) has been described as a different entity as well as a part of rheumatic fever. There is a lack of validated diagnostic criteria to establish a reliable diagnosis. There are no accepted recommendations for antibiotic prophylaxis in PSRA.

Anti-Bacterial Agents↗
PubMed1984

Patients with rheumatic fever recurrences.

An evaluation is made as to the effectiveness of a rheumatic fever followup clinic in preventing recurrences. Forty-nine recurrences are known to have occurred in 228 patients. Oral rather than intramuscular benzathine penicillin prophylaxis, positive oral or pharyngeal culture of Streptococcus pyogenes and large sibship were found to be associated with recurrences.

Child↗
PubMed1991

[The results of the indomethacin treatment of patients with acute rheumatic fever].

The authors describe the results of studying the anti-inflammatory effect of indomethacin in 102 young men suffering from acute rheumatic fever (ARF). It has been shown that indomethacin has a remarkable anti-inflammatory effect both on the general disease manifestations and on the basic symptoms. For instance, in ARF patients, fever disappeared on days 2-4 of the treatment whereas the signs of arthritis on days 7-8 of the treatment, on the average. Besides, indomethacin produced a marked analgesic effect, since in 84% of the patients, arthralgias diminished on days 2-3 from the onset of indomethacin treatment. Practically, in all the patients, they disappeared simultaneously with arthritis phenomena. Disorders of rhythm and conduction also disappeared on days 2-4 from the treatment onset, while the end part of the ventricular complex returned to normal a little bit later (days 13-15). Subjective symptoms of rheumocarditis disappeared completely by the end of the treatment. Within the same time, dynamic mesodiastolic murmur and additional sounds also disappeared, the deadening of sounds noticeably decreased, the intensity of systolic murmur declined. The overwhelming majority of the patients demonstrated normalization of the heart size. Side effects were recorded in 11 patients. They were largely arterial hypertension, epigastric pains, dizziness and headaches which disappeared as a result of corrective therapy and a short-term reduction of the indomethacin dose.

Acute Disease↗
PubMed1978

Articular manifestations of rheumatic fever in adults.

Six adult patients had a syndrome indistinguishable from childhood rheumatic fever, with few cardiac findings and an arthrutis that had a characteristic pattern. The joint disease was abrupt in onset, rapidly additive, and eventually symmetrical, with a lower-extremity, large-joint predominance and a profoundly symptomatic tenosynovitis. Emphasizing the benign prognosis associated with a lack of heart disease and a "typical" pattern of articular involvement, we have reassessed the sensitivity of the traditional diagnostic Jones' criteria and suggest that this syndrome in adults may be more properly termed "poststreptococcal arthritis."

Adolescent↗
PubMed1995

Serologic evidence for a class I group A streptococcal infection among rheumatic fever patients.

Group A streptococci (GAS) of serotypes most commonly associated with rheumatic fever (RF) outbreaks differ from many other serotypes by the presence of a unique, surface-exposed epitope on the M protein molecule. Based on the presence or absence of this epitope, GAS are categorized as class I or II, respectively. The objective of this study was to determine whether RF patients have an altered immune response to the class I-specific epitope. Immunoreactivity to class I- and class II-specific epitopes was determined for serum IgG derived from persons with a recent history of acute RF, uncomplicated GAS pharyngitis, and no known recent GAS infection. The results indicate that only RF patients display elevated levels of serum IgG directed towards the class I-specific epitope; they lack immunoreactivity to the class II epitope. The serologic findings strongly suggest that many of the RF patients were recently infected with a class I GAS isolate.

Antibodies, Bacterial↗
PubMed2005

Obsessive-compulsive symptoms in adults with history of rheumatic fever, Sydenham's chorea and type I diabetes mellitus: preliminary results.

OBJECTIVE: Rheumatic fever (RF) associated with Sydenham's chorea (a neurological variant of RF), but not RF without chorea, has been acutely related to obsessive-compulsive symptomatology/disorder (OCS/OCD). This study investigated the presence of OCS in adults who had RF with or without chorea in childhood. METHOD: The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to evaluate OCS in 38 adults with history of RF (13 with chorea; 25 without chorea) or diabetes (controls; n = 19). RESULTS: The OCS was similar in both groups, although the intensity of symptoms was not clinically relevant. Moreover, subjects with RF with or without chorea did not score differently in the Y-BOCS. CONCLUSION: The similar occurrence of OCS in patients with history of RF and diabetes suggests that the development of this symptomatology, triggered by group A beta-haemolytic streptococcus infections, is restricted to the RF acute phase, occurred during infancy, and did not seem to predispose the appearance of OCS in adulthood.

Adolescent↗
PubMed2005

Adult-onset acute rheumatic fever: possible resurgence in southern Taiwan.

BACKGROUND: By the late 1980s, acute rheumatic fever (ARF) had become a rare disease in Taiwan. The low prevalence rate in this area is attributed to a better economic status, which has led to improved public health and adequate medical services. OBJECTIVES: The increasing number of patients with adult-onset ARF in the United States described in the literature prompted us to evaluate the cases diagnosed in our medical center. METHODS: A retrospective chart review was performed for patients with arthritis from July 1988 to October 2004. To be included, patients had to meet revised Jones criteria. RESULTS: Three adult patients with ARF have been diagnosed since June 2001, with no childhood ARF being diagnosed. All cases presented with migratory polyarthritis, whereas 1 had erythema marginatum and transient carditis. These patients responded well to treatment with antibiotics and nonsteroidal antiinflammatory drugs. CONCLUSIONS: Clinicians must provide careful assessment and treatment to patients presenting with acute pharyngitis. A possible resurgence of ARF can be eradicated by primary prevention of streptococcal pharyngitis.

Adult↗
PubMed1993

Serum cholesterol levels in patients with acute rheumatic fever.

OBJECTIVE: To determine abnormalities of cholesterol metabolism in children with acute rheumatic fever (ARF). DESIGN: Cross-sectional study and prospective study. SETTING: Pediatric ward of the Khon Kaen (Thailand) University Hospital. PARTICIPANTS: Forty-six confirmed patients with ARF (during the acute and recovery phases of disease), 51 siblings, and 92 age- and sex-matched control children. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Serum samples of these children were studied for serum total cholesterol, high-density lipoprotein cholesterol, and triglyceride levels and liver function tests. No significant differences were found in mean serum total cholesterol levels (3.68 +/- 0.86 mmol/L [142.4 +/- 33.3 mg/dL] vs 3.75 +/- 0.67 mmol/L [145.0 +/- 25.8 mg/dL], 3.79 +/- 0.75 mmol/L [146.4 +/- 29.0 mg/dL], and 3.80 +/- 0.59 mmol/L [146.9 +/- 23.0 mg/dL]) or mean triglyceride levels (1.19 +/- 0.33 mmol/L vs 1.16 +/- 0.51, 1.12 +/- 0.37, and 1.07 +/- 0.41 mmol/L) (during ARF vs after ARF, sibling, and age- and sex-matched control children, respectively). The children with ARF had significantly lower mean levels of high-density lipoprotein cholesterol and of albumin than did the other groups (analysis of variance, P < .0001). In the ARF group, high-density lipoprotein cholesterol and albumin levels varied inversely with the clinical severity of carditis, while, in contrast, triglyceride and alkaline phosphatase levels varied with the clinical severity of carditis. CONCLUSIONS: This study confirms abnormalities of cholesterol metabolism in ARF. Hepatic dysfunction associated with the clinically detectable severity of carditis or inflammation might explain the observed differences in serum high-density lipoprotein cholesterol and triglyceride levels in these children.

Acute Disease↗