P2-20 TO EVALUATE THE SERO TYPES OF GROUP ‘A’ β-HAEMOLYTIC STREPTOCOCCI IN PATIENTS OF ACUTE RHEUMATIC FEVER: A CASE STUDY OF SLUM AREA OF RAJIV NAGAR, BHOPAL, M.P., INDIA

2007 ◽  
Vol 122 ◽  
pp. S86-S87
Author(s):  
Sharad Kumar Parashar ◽  
Alka Parashar
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Slum Area ◽  
Group A

scholarly journals D8/17 and CD19 Expression on Lymphocytes of Patients with Acute Rheumatic Fever and Tourette's Disorder

2004 ◽  
Vol 11 (2) ◽  
pp. 330-336 ◽  
Author(s):  
Julie L. Weisz ◽  
William M. McMahon ◽  
Jill C. Moore ◽  
Nancy H. Augustine ◽  
John F. Bohnsack ◽  
...  
Keyword(s):  
B Cells ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Neuropsychiatric Disorders ◽  
Streptococcal Pharyngitis ◽  
Tourette’S Disorder ◽  
Compulsive Disorder ◽  
Tourette's Disorder ◽  
Group A ◽  
Normal Controls

ABSTRACT D8/17, an alloantigen found on B lymphocytes, has been reported to be elevated in patients susceptible to rheumatic fever and may be associated with autoimmune types of neuropsychiatric disorders. The pediatric-autoimmune-neuropsychiatric-disorders-associated-with-streptococci model is a putative model of pathogenesis for a group of children whose symptoms of obsessive-compulsive disorder and Tourette's disorder (TD) are abrupt and may be triggered by an infection with group A streptococci. As a test of this model, we have examined D8/17 levels on the B cells of patients with TD and acute rheumatic fever (ARF) along with those on the B cells of normal controls by flow cytometry. We have utilized several different preparations of D8/17 antibody along with a variety of secondary antibodies but have been unable to show an association with an elevated percentage of D8/17-positive, CD19-positive B cells in either ARF or TD. We did find, however, that the percentages of CD19-positive B cells in ARF and TD patients were significantly elevated compared to those in normal controls. Group A streptococcal pharyngitis patients also had an elevated percentage of CD19 B cells, however. These studies failed to confirm the utility of determining the percentage of B cells expressing the D8/17 alloantigen in ARF patients or our sample of TD patients. In contrast, the percentage of CD19-positive B cells was significantly elevated in ARF and TD patients, as well as group A streptococcal pharyngitis patients, suggesting a role for inflammation and/or autoimmunity in the pathogenesis of these disorders.

Clinical features and diagnosis of acute rheumatic fever

ESC CardioMed ◽  
2018 ◽  
pp. 1138-1140
Author(s):  
Antoinette Cilliers
Keyword(s):  
High Risk ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Heart Association ◽  
Risk Groups ◽  
Group A ◽  
High Risk Populations ◽  
Minor Criteria

The diagnosis of acute rheumatic fever cannot be made using a single test. The diagnosis requires the recognition of a complex of clinical signs divided into major and minor manifestations as well as laboratory investigations aided by application of the Jones criteria, originally devised in 1944. The clinical manifestations are secondary to the effects of antibodies produced against the group A Streptococcus organism which cross-react against cardiac, skin, synovial, and neurological tissue associated with signs of inflammation. Several adjustments to the Jones criteria have been published over the last 70 years. The latest 2015 American Heart Association modification includes echocardiography/Doppler studies to diagnose subclinical carditis and also incorporates risk stratification whereby at-risk populations are divided into low- and moderate-to-high-risk groups. The presence of a single episode of a fever of at least 38°C and a slight elevation of the erythrocyte sedimentation rate to at least 30 mm/hour are classified as minor criteria in moderate- and high-risk populations. A monoarthritis or polyarthralgia are included as major criteria in the same risk group.

Acute Rheumatic Fever After Group A Streptococcus Pyoderma and Group G Streptococcus Pharyngitis

2017 ◽  
Vol 36 (7) ◽  
pp. 692-694 ◽  
Author(s):  
Lance O’Sullivan ◽  
Nicole J. Moreland ◽  
Rachel H. Webb ◽  
Arlo Upton ◽  
Nigel J. Wilson
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Group A Streptococcus ◽  
Group A

scholarly journals Cumulative incidence of rheumatic fever in an endemic region: a guide to the susceptibility of the population?

2000 ◽  
Vol 124 (2) ◽  
pp. 239-244 ◽  
Author(s):  
J. R. CARAPETIS ◽  
B. J. CURRIE ◽  
J. D. MATHEWS
Keyword(s):  
Heart Disease ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Cumulative Incidence ◽  
Acute Rheumatic Fever ◽  
Northern Australia ◽  
Endemic Region ◽  
Aboriginal Australians ◽  
Group A ◽  
Rheumatic Heart

Aboriginal Australians in northern Australia are subject to endemic infection with group A streptococci, with correspondingly high rates of acute rheumatic fever and rheumatic heart disease. For 12 communities with good ascertainment, the estimated lifetime cumulative incidence of acute rheumatic fever was approximately 5·7%, whereas over the whole population, with less adequate ascertainment, the cumulative incidence was only 2·7%. The corresponding prevalences of established rheumatic heart disease were substantially less than the cumulative incidences of acute rheumatic fever, at least in part because of poor ascertainment. The cumulative incidence of acute rheumatic fever estimates the proportion of susceptible individuals in endemically exposed populations. Our figures of 2·7–5·7% susceptible are consistent with others in the literature. Such comparisons suggest that the major part of the variation in rheumatic fever incidence between populations is due to differences in streptococcal exposure and treatment, rather than to any difference in (genetic) susceptibility.

scholarly journals Characterization of Two Novel Pyrogenic Toxin Superantigens Made by an Acute Rheumatic Fever Clone of Streptococcus pyogenes Associated with Multiple Disease Outbreaks

2002 ◽  
Vol 70 (12) ◽  
pp. 7095-7104 ◽  
Author(s):  
Laura M. Smoot ◽  
John K. McCormick ◽  
James C. Smoot ◽  
Nancy P. Hoe ◽  
Ian Strickland ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Mononuclear Cells ◽  
Group A Streptococcus ◽  
Human Peripheral Blood ◽  
Disease Outbreaks ◽  
Peripheral Blood Mononuclear ◽  
Human T Cells ◽  
Group A

ABSTRACT The pathogenesis of acute rheumatic fever (ARF) is poorly understood. We identified two contiguous bacteriophage genes, designated speL and speM, encoding novel inferred superantigens in the genome sequence of an ARF strain of serotype M18 group A streptococcus (GAS). speL and speM were located at the same genomic site in 33 serotype M18 isolates, and no nucleotide sequence diversity was observed in the 33 strains analyzed. Furthermore, the genes were absent in 13 non-M18 strains tested. These data indicate a recent acquisition event by a distinct clone of serotype M18 GAS. speL and speM were transcribed in vitro and upregulated in the exponential phase of growth. Purified SpeL and SpeM were pyrogenic and mitogenic for rabbit splenocytes and human peripheral blood mononuclear cells in picogram amounts. SpeL preferentially expanded human T cells expressing T-cell receptors Vβ1, Vβ5.1, and Vβ23, and SpeM had specificity for Vβ1 and Vβ23 subsets, indicating that both proteins had superantigen activity. SpeL was lethal in two animal models of streptococcal toxic shock, and SpeM was lethal in one model. Serologic studies indicated that ARF patients were exposed to serotype M18 GAS, SpeL, and SpeM. The data demonstrate that SpeL and SpeM are pyrogenic toxin superantigens and suggest that they may participate in the host-pathogen interactions in some ARF patients.

scholarly journals The incidence of sore throat and group A streptococcal pharyngitis in children at high risk of developing acute rheumatic fever: A systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242107
Author(s):  
Sarah Pearce ◽  
Asha C. Bowen ◽  
Mark E. Engel ◽  
Maya de la Lande ◽  
Dylan D. Barth
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Rheumatic Fever ◽  
Sore Throat ◽  
Acute Rheumatic Fever ◽  
Meta Analysis ◽  
Incidence Rates ◽  
Children At Risk ◽  
Indigenous Children ◽  
Group A

Background Group A streptococcal (GAS) pharyngitis has traditionally been considered the sole precursor of acute rheumatic fever (ARF). Evidence from Australia, however, suggests that GAS skin infections may contribute to the pathogenesis of ARF. A missing piece of evidence is the incidence of sore throat and GAS pharyngitis in this setting. We conducted a systematic review and meta-analysis of the incidence of sore throat and GAS pharyngitis in all children at risk of developing ARF. Methods Databases were systematically searched for studies reporting on the incidence of pharyngitis among children from low to upper-middle income countries, and Indigenous children living in high-income countries. Studies were subjected to data extraction by two independent reviewers. Following an assessment of the methodological quality of the studies, we extracted incidence rates (IRs) and conducted a meta-analysis. This systematic review is registered on PROSPERO (CRD42019113019). Results From 607 titles identified by the search, 11 articles met the predetermined inclusion criteria; ten studies reported IRs while for the remaining study, the incidence was calculated. The pooled incidence estimated for sore throat was 82.5 per 100 child-years (95% confidence interval [CI], 6.5 to 1044.4 per 100 child-years, I2 = 100%) and GAS pharyngitis was 10.8 per 100 child-years (95% CI, 2.3 to 50.0 per 100 child-years, I2 = 99.9%). Conclusions The pooled IRs for sore throat in children at risk of developing ARF were higher than rates reported in developed nations (32.70–40 per 100 child-years) and similar for GAS pharyngitis (12.8–14 per 100 years). The limited Australian data lend support to the need for further studies to inform the role of GAS pharyngitis in the development of ARF in Australian Indigenous children, so as to inform local primary prevention strategies for ARF and Rheumatic Heart Disease (RHD).

scholarly journals Delayed Diagnosis of Acute Rheumatic Fever in a Patient with Multiple Emergency Department Visits

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Inna Kaminecki ◽  
Renuka Verma ◽  
Jacqueline Brunetto ◽  
Loyda I. Rivera
Keyword(s):  
Emergency Department ◽  
Rheumatic Fever ◽  
Health Care Providers ◽  
Acute Rheumatic Fever ◽  
Group A Streptococcus ◽  
The United States ◽  
Emergency Department Visits ◽  
Penicillin G ◽  
Care Providers ◽  
Group A

While the incidence of acute rheumatic fever (ARF) in the United States has declined over the past years, the disease remains one of the causes of severe cardiovascular morbidity in children. The index of suspicion for ARF in health care providers may be low due to decreasing incidence of the disease and clinical presentation that can mimic other conditions. We present the case of a 5-year-old boy with a history of intermittent fevers, fatigue, migratory joint pain, and weight loss followinggroup A Streptococcuspharyngitis. The patient presented to the emergency department twice with the complaints described above. On his 3rd presentation, the workup for his symptoms revealed the diagnosis of acute rheumatic fever with severe mitral and aortic valve regurgitation. The patient was treated with penicillin G benzathine and was started on glucocorticoids for severe carditis. The patient was discharged with recommendations to continue secondary prophylaxis with penicillin G benzathine every 4 weeks for the next 10 years. This case illustrates importance of primary prevention of acute rheumatic fever with adequate antibiotic treatment ofgroup A Streptococcuspharyngitis. Parents should also receive information and education that a child with a previous attack of ARF has higher risk for a recurrent attack of rheumatic fever. This can lead to development of severe rheumatic heart disease. Prevention of recurrent ARF requires continuous antimicrobial prophylaxis. Follow-up with a cardiologist every 1-2 years is essential to assess the heart for valve damage.

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