Presentation
Colonial War Memorial Hospital, December 2005 to November 2007 Clinical presentation No. [mja.com.au]
When minor manifestations alone are present, the exclusion of other more likely causes of the clinical presentation is recommended before a diagnosis of an ARF recurrence is made (Class I, Level of Evidence C). [acc.org]
Gebremariam S, Moges T Long-Term Nonmalignant Disease Mortality in Subjects Exposed to Transmissible Agents Present in Animals Used for Food. [medicbind.com]
Review Topic QID: 106727 M1 Select Answer to see Preferred Response PREFERRED RESPONSE 2 (M1.CV.112) A 10-year-old male presents with his mother with multiple complaints. [medbullets.com]
Low-grade carditis may present too late for diagnosis of the RF. [patient.info]
Entire Body System
- Anemia
Anemia of chronic disease (microcytic anemia = decrease Hb, MCV, TIBC, serum iron, % saturation; increased Ferritin) 3. [quizlet.com]
[…] patirnt not feeling well- often anorexia and weight loss -heart murmer, splenomegaly and petechiae -splinter hemorrhages are common - ocasionally, osler nodes and Roth's spots are present - slight leukocytosis and anemia -hematuria Osler’s nodes (painful [cram.com]
[…] or (c) 5 minor criteria (see Table below) These are associated with a 99% specificity for diagnosis in follow up studies Diagrams / tables Images hosted on other servers: Duke criteria for diagnosis Investigation Blood count: normochromic normocytic anemia [pathologyoutlines.com]
Lab values of endocarditis are oftentimes nonspecific and can include: Anemia of chronic disease in patients with subacute endocarditis (i.e., normocytic and normochromic erythrocytes, low serum iron, and low iron binding capacity). [atsu.edu]
[…] endocarditis Rarely observed today, the bacteria-free state of IE is one in which patients have multiple negative blood culture results in the presence of severe congestive heart failure, renal failure, multiple sterile emboli, massive splenomegaly, severe anemia [intranet.tdmu.edu.ua]
Cardiovascular
- Mitral Valve Prolapse
[…] disease, and mitral valve prolapse. [emedicine.medscape.com]
[…] factors: Pre existing structural heart disease: rheumatic heart disease (RHD), hypertrophic cardiomyopathy (HCM), subaortic stenosis, ventricular aneurysm Degenerative valve disease: mitral valve prolapse, bicuspid aotic valve, calcific aortic valve [pathologyoutlines.com]
Pathophysiology IE develops most commonly on the mitral valve, closely followed in descending order of frequency by the aortic valve, the combined mitral and aortic valve, the tricuspid valve, and, rarely, the pulmonic valve. [intranet.tdmu.edu.ua]
They include: rheumatic heart disease, congenital heart disease (i.e., bicuspid aortic valve, ventricular septal defect, coarctation of the aorta, tetralogy of Fallot), mitral valve prolapse, degenerative heart disease (e.g., calcific aortic valve disease [atsu.edu]
[…] regurgitation (MR)僧帽弁逆流[症] mitral stenosis (MS) 僧帽弁狭窄[症] mitral valve 僧帽弁 mitral valve area僧帽弁口面積 mitral valve prolapse (MVP)僧帽弁逸脱[症] mitral valve replacement僧帽弁置換術 Mobitz type I blockモビッツI型ブロック Mobitz type II blockモビッツII型ブロック moist rale湿性ラ音 mucocutaneous [tokyo-med.ac.jp]
Eyes
- Prolapse
prolapse with its thin, elongated cords and translucent, glistening leaflets. [emedicine.medscape.com]
[…] usually occur distal to the obstruction Etiology Risk factors: Pre existing structural heart disease: rheumatic heart disease (RHD), hypertrophic cardiomyopathy (HCM), subaortic stenosis, ventricular aneurysm Degenerative valve disease: mitral valve prolapse [pathologyoutlines.com]
[…] strangulated ulcerated 455.3 External hemorrhoids without mention of complication 455.4 External thrombosed hemorrhoids 455.5 External hemorrhoids with other complication External hemorrhoids: bleeding prolapsed strangulated ulcerated 455.6 Unspecified [theodora.com]
Cardiac risk factors were more common in these patients, including mitral valve prolapse, congenital heart disease, rheumatic valvular heart disease, previous cardiac surgery, history of infective endocarditis, and a known heart murmur. [intranet.tdmu.edu.ua]
In MR, two-dimensional echocardiography (2DE) shows elongated chordae causing prolapse of the anterior mitral valve leaflet (AML). [link.springer.com]
Urogenital
- Kidney Failure
stroke, and kidney failure. [4] [3] The cause is typically a bacterial infection and less commonly a fungal infection. [3] Risk factors include valvular heart disease including rheumatic disease, congenital heart disease, artificial valves, hemodialysis [en.wikipedia.org]
The finding of the adverse effect of kidney failure on Indigenous RHD patients is consistent with the finding from another study that kidney failure is the only chronic disease that is associated with 30-day and long-term mortality after RHD-related valve [circ.ahajournals.org]
Neurologic
- Meningism
Ferri’s popular "5 books in 1" format provides quick guidance on short QT syndrome, microscopic polyangiitis, fungal meningitis, and much more. This medical reference makes the answers you need even easier to find - anytime, anywhere. [books.google.com]
Impetigo - a skin infection Toxic shock syndrome Cellulitis and necrotizing fasciitis (flesh-eating disease) Group B strep can cause blood infections, pneumonia and meningitis in newborns. A screening test during pregnancy can tell if you have it. [icdlist.com]
Purulent meningitis may be observed in patients with acute IE, compared with the aseptic type observed in patients with subacute disease. Other neurological findings are similar to those observed in patients with subacute disease. [intranet.tdmu.edu.ua]
[…] hypertension Excludes: any condition classifiable to 430-434, 436, 437 occurring during pregnancy, childbirth, or the puerperium, or specified as puerperal (674.0) iatrogenic cerebrovascular infarction or hemorrhage (997.02) 430 Subarachnoid hemorrhage Meningeal [theodora.com]
- Confusion
Rheumatic heart disease (not to be confused with rheumatoid heart disease ) may refer to either the acute cardiac involvement or chronic cardiac sequelae following rheumatic fever. Carditis is a major Jones criterion of rheumatic fever. [radiopaedia.org]
The symptoms of heart failure may be confused with symptoms of late pregnancy and go untreated, causing cardiovascular collapse and death. [rhdaction.org]
The terms of Acute Rheumatic Fever and Rheumatic Heart Disease are sometimes confused. [hawaii.edu]
[…] nontender macular papules on palms or soles Splinter hemorrhages Petechiae (embolic or vasculitic) Clubbing: in long standing disease Eyes: Roth spots (boat shaped hemorrhages with pale centers, in retina) and conjunctival splinter hemorrhages Neurological: Confusion [pathologyoutlines.com]
- Encephalopathy
Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]
Leading causes are stroke, encephalopathy, and retinal emboli. Brain abscesses and mycotic aneurysms are relatively infrequent. As a general rule, anticoagulation should be avoided because of the increased risk of intracranial bleeding. [intranet.tdmu.edu.ua]
[…] cerebrovascular disease 437.0 Cerebral atherosclerosis Atheroma of cerebral arteries Cerebral arteriosclerosis 437.1 Other generalized ischemic cerebrovascular disease Acute cerebrovascular insufficiency NOS Cerebral ischemia (chronic) 437.2 Hypertensive encephalopathy [theodora.com]
- Headache
Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]
[…] evaluation: tender and swollen lymph nodes red rash difficulty swallowing thick, bloody discharge from nose temperature of 101°F (38.3°C) or above tonsils that are red and swollen tonsils with white patches or pus small, red spots on the roof of the mouth headache [healthline.com]
Fever and chills are the most common symptoms; anorexia, weight loss, malaise, headache, myalgias, night sweats, shortness of breath, cough, or joint pains are common complaints as well. [intranet.tdmu.edu.ua]
- Intracranial Hemorrhage
Subdural hemorrhage Subdural hematoma, nontraumatic 432.9 Unspecified intracranial hemorrhage Intracranial hemorrhage NOS 433 Occlusion and stenosis of precerebral arteries The following fifth-digit subclassification is for use with category 433: 0 without [theodora.com]
As a general rule, anticoagulation should be avoided because of the increased risk of intracranial bleeding. [intranet.tdmu.edu.ua]
Workup
Thuny et al have developed an algorithm for the workup of negative blood cultures. The first stage is to obtain serologies for Q fever and Bartonella. [intranet.tdmu.edu.ua]
Microbiology
- Candida
[…] previously damaged valves (i.e. via chronic rheumatic fever) Strep viridans (alpha-hemolytic) - must Bacteria associated with endocarditis due to prosthetic valves Bacteria associated with endocarditis due to IV drug use staph aureus Others: Pseudomonas, candida [quizlet.com]
Postoperative infections are most commonly caused by Staphylococcus aureus, gram-negative aerobic rods, or Candida. [atsu.edu]
S. faecalis, S. bovis, S. faecium HACEK organisms: Haemophilus parainfluenza, Haemophilus aphrophilus, Actinobacillus (Haemophilus) actinomycetemcomitans, Cardiobacterium hominis, Eikenella species, and Kingella species Less common organisms: Candida [pathologyoutlines.com]
The most common organism of both fungal NVE and fungal PVE is Candida albicans. Fungal IVDA IE is usually caused by Candida parapsilosis or Candida tropicalis. Aspergillus species are observed in fungal PVE and NIE. [intranet.tdmu.edu.ua]
- Streptococcus Pneumoniae
Bacterial pathogens like Streptococcus pneumoniae usually infect the pericardium by extension from an adjacent pneumonitis. [atsu.edu]
Treatment
This is in contrast to the recommendation for azithromycin treatment of acute group A streptococcal infection. [nps.org.au]
Here we report 2 pediatric cases of MR and/or treatment failure in the treatment of GAS pharyngitis with the subsequent development of acute rheumatic fever. [pediatrics.aappublications.org]
Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. [betterhealth.vic.gov.au]
Hospitalization for ARF/RHD Treatment of ARF Patients (n=572) and Hospitalization (Within 1 Year of RHD diagnosis) for RHD Treatment of RHD Patients (n=1248), NT, 1997 to 2013 Exposure Variables Hospitalization for ARF/RHD Treatment Hospitalization for [circ.ahajournals.org]
Prognosis
Rheumatic Fever Prognosis Rheumatic fever will go resolve spontaneously within 12 weeks even if is not treated. With treatment, it can resolve within two weeks. [emedicinehealth.com]
Prognosis Rheumatic heart disease occurs in 30-45% of patients with acute RF [ 20 ]. Severe chronic valvular disease is associated with severe carditis and recurrent RF [ 21 ]. [patient.info]
Prognosis Rheumatic mitral valve disease is inconsistently reparable, and the long-term outcomes after surgical repair are not as good as for valve repair for mitral valve prolapse due to leaflet and chordal scarring. [emedicine.medscape.com]
Elevated in patients with valvular involvement, these antibodies are significantly reduced after surgical removal of inflamed valves and they correlate with poor prognosis [ 6 ]. [link.springer.com]
Fungal endocarditis has a poor prognosis. [intranet.tdmu.edu.ua]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Etiology Streptococcus pyogenes (group A Streptococcus ) is the etiological agent that induces an autoimmune reaction that results in damage to the heart. This complication occurs several weeks after a pharyngeal infection with S pyogenes. [atsu.edu]
New observations on the etiology of aortic valve disease: a surgical pathologic study of 236 cases from 1990. Hum Pathol. 1993 Dec. 24(12):1330-8. [Medline]. Veinot JP. Pathology of inflammatory native valvular heart disease. [emedicine.medscape.com]
[…] ventricular septal defect (VSD), vegetations can be found on the right ventricular side of the VSD, on the tricuspid valve or where the jet impinges on the right ventricular wall Vegetations found in coarctation usually occur distal to the obstruction Etiology [pathologyoutlines.com]
Embolic stroke with focal neurologic deficits is the most common etiology. Other etiologies include intracerebral hemorrhage and multiple microabscesses. [intranet.tdmu.edu.ua]
Epidemiology
Epidemiologic implications: It is reasonable to consider individuals at low risk of ARF if they come from a setting or population with known low rates of ARF and RHD (Class IIa, Level of Evidence C). [acc.org]
Changes in the clinical and epidemiological features of group A streptococcal bacteraemia in Australia\u2019s Northern Territory. Trop Med Int Health 2015;20:40-7. Kim S, Lee NY. [nps.org.au]
This review summarizes these findings and provides a clinical perspective on ARF/RHD pathogenesis, epidemiology, diagnosis, prevention, management and control. [link.springer.com]
[…] descriptions of the clinical profile of ARF in less developed nations. 3, 4 Likewise, there are few descriptions of the clinical presentation of rheumatic heart disease (RHD) in developing countries. 5 We therefore designed a study to characterise the clinical epidemiology [mja.com.au]
Reason for surveillance To monitor the epidemiology of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in New South Wales. [health.nsw.gov.au]
Pathophysiology
The pathophysiological and clinical sequelae of these valvular lesions are discussed on their own pages and are not unique to this particular etiopathogenesis. [pathwaymedicine.org]
Pathophysiology Causative agent Group A Beta-hemolytic streptococci Untreated strep throat Rheumatic fever All layers of the heart and the mitral valve become inflammed Vegetation forms Valvular Regurgitation and stenosis Heart Failure 12. V. [slideshare.net]
[…] defibrillator, IVDA (right sided endocarditis), indwelling catheter Congenital heart disease: small ventricular septal defect, bicuspid aortic valve, coarctation of aorta, patent ductus arteriosus Uncommon with large VSD, mitral stenosis, atrial septal defect Pathophysiology [pathologyoutlines.com]
Essentials of pathophysiology: concepts of altered health states. Hagerstown, MD: Lippincott Williams & Wilkins. [en.wikipedia.org]
Prevention
Different Preventions of RHD Type of Prevention Aim (What?) Modality (How?) [circ.ahajournals.org]
[…] on preventative action, diagnosis and management of acute rheumatic fever and rheumatic heart disease, and should be considered the difinitive source of information to guide all aspects of RHD management, prevention and control across Australia. [healthdirect.gov.au]
Prevention of rheumatic heart disease RHD is a complication of untreated ARF. People who have had ARF are at increased risk of developing RHD. Prompt diagnosis of ARF and taking preventative antibiotics can prevent RHD. [betterhealth.vic.gov.au]
Secondary prevention is the key focus of most control strategies, due to its proven efficacy, cost-effectiveness, and the challenges of primordial and primary prevention. [link.springer.com]
While the focus in preventing RHD has predominantly been on preventing infection, there has been little attention on controlling the inflammatory responses which is the main driving force. [omicsonline.org]