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1.42 Rheumatic fever

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Acute rheumatic fever
Occurs 1-4 weeks after tonsillitis; group A Beta-hemolytic streptococci; common in children 5-15 years
Rheumatic heart disease
Occurs many years after rheumatic fever; often asymptomatic; fibrotic, deformed, calcified lines of closure on valve leaflets; mitral valve > aortic valve
major jones criteria
polyarthritis; erythema; subcutaneous nodules; chorea; carditis
pericarditis
Cardititis of rheumatic fever; serous effusions
myocarditis
Cardititis of rheumatic fever; heart failure
endocarditis
Cardititis of rheumatic fever; valvular damage
aschoff body
Focal interstitial myocardial inflammation; large myocytes (Anitschkow cells); multinucleated giant cells
rheumatic fever
Most common clinical presentation is migratory polyarthritis, lasting 2-3 weeks, accompanied by fever