- 390 Rheumatic fever without mention of heart involvement
- 391 Rheumatic fever with heart involvement
- 392 Rheumatic chorea
- I00 Rheumatic fever without heart involvement
- I01.0 Acute rheumatic pericarditis
- I01.1 Acute rheumatic endocarditis
- I01.2 Acute rheumatic myocarditis
- I01.8 Other acute rheumatic heart disease
- I01.9 Acute rheumatic heart disease, unspecified
- I02.0 Rheumatic chorea with heart involvement
- I02.9 Rheumatic chorea without heart involvement
- Autoimmune inflammatory disease that can develop as a sequela of streptococcal infection, group A
- Characterized by inflammatory lesions of the joints, heart, blood vessels, subcutaneous tissue, and central nervous system
- Form of endocarditis
- Rheumatic fever has variable manifestations; therefore, no specific diagnostic test exists for diagnosis
- Usually occurs approximately 20 days after strep throat or scarlet fever
- Diagnosis is based on the Jones criteria; major and minor criteria used to confirm diagnosis
- Diagnosed if individual meets two major criteria or one major and one minor crieteria with previous strep infection
- Major criteria
- Sydenham chorea
- Erythema marginatum
- Subcutaneous nodules
- Minor criteria
- Previous rheumatic fever or rheumatic heart disease
- Elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) levels
- Prolonged PR interval
- Evidence of preceding group A streptococcal infection: positive throat culture or rapid antigen test result
- Elevated or rising streptococcal antibody titer
- The most significant complication is rheumatic heart disease, which usually occurs after repeated bouts of acute illness
- It can present as valvular stenosis, most commonly involving the mitral valve
- These patients are prone to infective endocarditis and stroke
- Chorea can present months after the inciting infection
- Some physicians monitor ESR and restart activity when it normalizes
- Rheumatic fever is predominantly a disease of developing countries and is concentrated in areas of deprivation and crowding.
- The risk of developing rheumatic fever after an episode of streptococcal pharyngitis has been estimated at 0.3 to 3%.
- Overall incidence in the United States is less than 1 per 100,000.
- It is most common in 5- to 15-year-old children.
- A genetic predisposition to rheumatic fever does exist.
- The disease does not have a major racial or gender predisposition.
- Signs and symptoms result from inflammation in the heart, joints, skin, or central nervous system.
- Sore throat: 35% to 60% of patients with rheumatic fever recall having upper respiratory symptoms in the preceding several weeks.
- Swollen and painful joints, particularly knees, ankles, elbows, and wrists
- Erythema marginatum: flat or raised red lattice-like rash found on trunk and proximal ...
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