[Streptococcal rheumatic fever in adults].
Thirty-seven cases of streptococcal rheumatic fever in adults (20 women and 17 men; mean age 33 years) are reported. Only 3 patients had a history of previous rheumatic fever. In 73% of the cases untreated sore throat had occurred 8 to 30 days before the condition developed. Throat swabs taken during the rheumatic attack were positive for Streptococcus haemolyticus in only 5 out of 22 patients. The joints most commonly affected were those of the lower limbs and the symptoms were severe; in 2 out of 3 patients other joints were subsequently involved. Five patients had stable mitral regurgitation of undetermined duration, with systolic murmur. ECG abnormalities were noted in 7 patients, including 5 with prolongation of the PR interval and 2 with moderate elevation of the ST segment; these abnormalities regressed in all cases. No specific skin lesions were observed. The streptococcal infection was associated with a rise in antistreptolysins in 73% of the cases, a rise in antistreptokinases in 80% and a rise in both types of antibodies in 97%. Response to antibiotics and anti-inflammatory drugs was satisfactory in all cases. Cure was achieved within less than one month in 57% of the patients, but the condition lasted three years in 3 patients.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000989:Antistreptolysin / Q000032:analysis; D001241:Aspirin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology; D010406:Penicillins / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D012213:Rheumatic Fever / Q000175:diagnosis* / Q000188:drug therapy; D012214:Rheumatic Heart Disease / Q000209:etiology; D013290:Streptococcal Infections / Q000150:complications*
D010406:Penicillins; D000989:Antistreptolysin; D001241:Aspirin; D011241:Prednisone
Rhumatisme streptococcique de l'adulte.