Rheumatic fever is a consequence of pharyngeal infection caused by group A β-hemolytic streptococci. This condition primarily affects children and can lead to long-term complications such as rheumatic heart disease, which commonly impacts heart valves.
Rheumatic fever is an immune-mediated disorder (type II hypersensitivity) rather than a direct bacterial effect. The condition is believed to occur due to molecular mimicry, where antibodies against the M protein of Streptococcus pyogenes cross-react with self-antigens, particularly myosin.
The diagnosis of rheumatic fever is based on the J♥NES criteria, which include both major and minor manifestations:
| Major Criteria | Description |
|---|---|
| J – Joint (Migratory polyarthritis) | Migratory arthritis affecting large joints. |
| ♥ – Carditis | Inflammation of the heart, often leading to valve damage. |
| Nodules – Subcutaneous nodules | Painless, firm lumps typically located over bony prominences. |
| Erythema marginatum | An evanescent, ring-like rash with raised margins, seen in the trunk and limbs. |
| Sydenham chorea | Involuntary, jerky movements, particularly of the face and extremities. |
The treatment and prevention of rheumatic fever involves penicillin to eradicate any residual Streptococcus pyogenes infection and prevent recurrence. Long-term prophylaxis may be necessary to prevent reinfection and further cardiac complications.
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