Diagnosis and Management of Acute Rheumatic Fever

Introduction

Acute rheumatic fever (ARF) is an inflammatory disease that occurs as a sequela of untreated or inadequately treated streptococcal infections. It primarily affects the heart, joints, and central nervous system.

Etiology and Pathogenesis

ARF is caused by an autoimmune response to Group A Streptococcus infection, leading to molecular mimicry and subsequent tissue damage.

Clinical Diagnosis

• Jones Criteria: Major criteria include carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules.
• Minor criteria include fever, arthralgia, elevated ESR, and prolonged PR interval.

Management Strategies

Treatment focuses on eradicating the infection, controlling inflammation, and preventing recurrence.

Antimicrobial Therapy

• Penicillin or erythromycin to eliminate Group A Streptococcus.

Anti-inflammatory Treatment

• Aspirin or corticosteroids for joint and cardiac inflammation.

Long-term Prophylaxis

• Monthly benzathine penicillin injections to prevent recurrence.

Conclusion

Early diagnosis and prompt treatment are essential to reduce complications such as rheumatic heart disease.