The correlation between Rheumatic Fever and Endocarditis

By : Diaz Rahmadi 030.08.082

Background
Rheumatic heart disease (RHD) continues to be a common health problem in the developing world, causing morbidity and mortality among both children and adults. Although little longitudinal data are available, evidence suggests that there has been little if any decline in the occurrence of RHD over the past few decades. Recent reports from the developing world have documented rheumatic fever (RF) incidence rates as high as 206/100 000 and RHD prevalence rates as high as 18.6/1000. The high frequency of RHD in the developing world necessitates aggressive prevention and control measures

Definition
Rheumatic Heart Disease is a disease characterized by damage to the heart valves caused by an attack of acute rheumatic fever carditis who repeatedly happen Rheumatic fever is a clinical syndrome as a result of beta-streptococcal infection hemolyticus group A, with one or more major symptoms of acute polyarthritis migrans, carditis, korea minor, subcutaneous nodules and erythema marginatum.

Streptococcus B hemolyticus group A

FAMILI : Streptococcaceae GENUS : Streptococcus SPESIES : Streptococcus pyogenes Germs are round or oval, sometimes resembling sticks, lined up like a chain composed. Chain length varies and is determined largely by environmental factors. Will be longer chains in liquid media than on solid media. In the old growth or dead germs gram positive nature will be lost and become gram-negative

Rheumatic Fever
Inflammatory disease
Complication Strep throat caused by Streptococcus group A

Epidemiology
Most common in 5 to 15 years old Common in developping nations

Symptoms
Permanent damage to the heart Treatments can reduce tissue damage

Endocarditis
Is an infection of the inner lining of your heart ( endocardium)
Occurs when bacteria from another part of body attached to damaged area in your heart Uncommon in people with healthy heart

Sign and Symptoms

Fever, chills, fatigue, a new or change heart murmur, night sweats Shortness of breath, paleness, persistent cough, swelling in your feets

Causes
Germs enter bloodstream, travel to your heart, attach abnormal heart valve Offending organism may enter your bloodstream through : common activities, an infection or other medical condition, catheters o needles, dental procedures

How rheumatic fever and endocarditis correlated ?

Predisposing factors
Individual Factors 1. Genetic factors 2. Sex 3. Ethnic 4. Age 5. Nutritional State Environmental factors 1. Poor socio-economic circumstances 2. Climate and geography 3. Weather

Prevention
Oral (PO) penicillin V remains the drug of choice for treatment of GABHS pharyngitis, but ampicillin and amoxicillin are equally effective.

Conclusion
In conclucion, Cardiac involvement in rheumatic fever can be on any network component. the occurrence of endocarditis in patients with rheumatic fever caused by germs sterptococcus beta hemolitycus group that causes strep throat. body reacts to this, by producing antibodies. because the antigens of the bacteria streptococcus beta hemolitycus almost similar to those in the heart. Rather, the endocarditis in rheumatic fever is caused by an autoimmune process that affects many parts of the body in addition to the heart, and is triggered by a reaction to the streptococcal bacteria in strep throat. Rheumatic heart disease ends up affecting about half the people who have rheumatic fever with carditis. Most of the time, rheumatic heart disease is diagnosed 10 to 20 years after being "triggered" by acute rheumatic fever

Refferences

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