Publié par happy-diet vendredi 22 janvier 2010

rheumatic fever .... the pros and cons

Often hear people say the public directed advice to parents who complain about the high incidence of tonsillitis in children: Care should be taken because of tonsillitis can be down to the heart or the joints, and this expression mean by rheumatic fever.

Rheumatic fever:
Is an inflammatory disease allergic reaction occurs as a result of infection throat infection is caused by infection with streptococcus hemolytic, which affects mainly the heart, joints, and may infect the central nervous system and skin and subcutaneous tissue which affects in particular children between the ages of 5 - 15 years, and occurs in less than 3% of cases of upper respiratory tract infection streptococcus.

Mechanism of occurrence:
Can be said: There is a close relationship between the incidence of hemolytic nodules and rheumatic fever; shaped body, where immune complexes as a result of the Streptococcus bacteria enter the body, which are deposited at the level of cardiac valves and in the level of the synovial membrane of joints during the acute attack, all due to the similar chemical structure to portfolio bacteria Streptococcus hemolytic with cardiac muscle tissue.

How to pretend rheumatic fever?
Rheumatic fever often manifests in the form of a multi-inflammation in the joints and inflammation of the heart, and sometimes a rare skin injuries and stroke. And inflammation of the heart-lung finds particularly in young children, and rheumatoid arthritis is dominant in children of school age, and we will explain the events following rheumatic fever in a separate, detailed and simple:

First: fever:
As seen in the child with high heat during the first week of the disease may be up to 40 degrees during the two weeks subsequent decline in the absence of treatment, may be associated with fever, weight loss and abdominal pain.

Second: Arthritis:
The traditional attack rheumatic fever manifests in the form of inflammation in multiple joints, and moving the infection of detail to another and may affect all joints, but prefers Kalrkpp large joints, and may be in the form of injury just arthralgia only, and may be in the form of swelling in the joint with the hottest spot with redness of the skin covering the joint, and determine the movement and sometimes not a few back arthritis completely without leaving any damage articulated even in the absence of treatment.

Third: Rheumatoid carditis:
It occurs in 50% of cases, inflammation of the heart manifests here in haste pulse is not commensurate with the trumpet will be blown with a fever attack and disruption in heart rhythm, and may occur in heart failure result in failure or mitral stenosis, the patient may die sometimes in the acute phase of rheumatic fever heart failure or left has hardened in the valves.

IV: nodules under the skin:
A small granular swellings often animated and non-painful posturize particularly on the extensor tendons of the hands, feet, elbows or on the Abawarz bone or on both sides of the spinal column and click.

Fifth: diabetes dance:
The latest demonstration of rheumatic fever due to the infection of central nervous system, in particular injury basal nuclei and cerebellum, and it appears after the decline of many arthritis may be the key to detect inflammation of rheumatoid heart, and pretends to dance progressive disease; where the patient becomes nervous and worried and it is difficult to read, write and walk , and shows a sudden involuntary movements, irregular, intent, and present the case of children unable to speak or walk or even sit spoke has a severe and convulsive movements resort then to link it in bed to prevent the fall.

VI: Erythema marginal:
A rash vinous feature of rheumatic fever observed in 15% of cases, appears mainly on the trunk and rarely affects the parties, and never involves the face, a transient erythema and mobile and non-itchy and clicking away.

How is it diagnosed?
The story is told by clinical and family, which often refer to the story of inflammation in the throat several weeks ago is the key to diagnosis, which supports the laboratory examinations; where noticed an increase in ESR and white blood cells and C reactive protein and an increase in Alglobolinat gamma and alpha, in addition to the adoption of standards for doctors rheumatic fever which can have a firm diagnosis.

Treatment aims in rheumatic fever to achieve three things are key:

1 - Elimination of Streptococcus hemolytic, and it is by giving antibiotics for a sufficient period.

2 - Elimination of toxic events of rheumatic fever, and that by giving appropriate medications for the treatment of acute arthritis and inflammation of the heart and nerve and skin infections, so by giving aspirin, usually in the joints and injuries in the steroids arthritis and atypical antipsychotic drugs in diabetes dance.

3 - Prevention of relapse: The prevention of relapse of the main objectives of treatment, and intended to prevent streptococcus infection status of blood, thereby preventing the occurrence of rheumatic fever again as much as possible and here is the drug of choice is penicillin, penicillin Abannzzatin EXTENDED; where it can be given every two weeks by 600 thousand units for children less than nine years, and every three weeks for children 9-14 years dose of 900 thousand units, a dose of 1.2 million units per month for children over 14 years, and must not be less than for prevention of 5 years in the case of inflammation of the heart must continue until the fifth
Thirty years of age and some say life, and in case of allergy to penicillin can be given long-standing Alaratrohmeysin doses prescribed by your doctor ..

A final word:

The number of times the frequency of relapse of rheumatic fever, streptococcal infection with the frequency and severity, as regards the presence of rheumatoid heart disease following the attack, so it must focus on the treatment of good and fast, and work to prevent relapse in a preventive manner, and then only through the care of children well and control methods respiratory infections The top and see a doctor quickly and the right time when the situation requires it.

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