Rheumatic fever and post-streptococcal arthritis.
Rheumatic fever resulting from group A beta-haemolytic Streptococcus infection continues to be a prevalent disease and an important cause of morbidity and mortality in developing countries. Molecular mimicry and CD4 T lymphocytes, interleukins and adhesion molecules play a crucial role in the pathogenesis of this disease. Arthritis, followed by carditis and chorea, are the main manifestations of the disease. Evidence of asymptomatic carditis has been increasing; however, abnormality identified by echo-Doppler evaluation is not considered as a criterion for diagnosis of rheumatic carditis. Benzathine penicillin is still the best therapeutic option for the treatment of streptococcal infection and secondary prophylaxis, due to its efficacy and low cost.
Hilário
Maria Odete E
MO
Alameda dos Anapurus, 1370 ap 144, 04087-004 São Paulo, Brazil.
Terreri
Maria Teresa S L R A
MT
D001172:Arthritis, Rheumatoid / Q000209:etiology* / Q000517:prevention & control; D002648:Child; D006801:Humans; D010401:Penicillin G Benzathine / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D012214:Rheumatic Heart Disease / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy
D010406:Penicillins; D010401:Penicillin G Benzathine