David vs Ajeng

Tutorial D-3
Rheumatic Fever
DR merupakan suatu penyakit inflamasi sistemik non supuratif yang
digolongkan pada kelainan vaskular kolagen atau kelainan jaringan ikat.Proses
rheumatik ini merupakan reaksi peradangan yang dapat mengenai banyak
organ tubuh terutama jantung, sendi dan sistem saraf pusat. (IPD UI)
Rheumatic Fever is caused by reaction of the body to a specific kind of germ
the group A beta-hemolytic streptococcus, or strep, as almost everyone
knows it.
Etiology
Infeksi GAS (Group A streptococcus) pada saluran pernapasan bagian atas
Riwayat infeksi saluran pernapasan bagian atas beberapa minggu sebelumnya
Epidemiology
The annual incidence of acute rheumatic fever in some developing countries
exceeds 50 per 100,000 children, and very high rates are also seen in ethnic
minority populations within Australia and New Zealand
Worldwide, rheumatic heart disease remains the most common form of
acquired heart disease in all age groups, accounting for as much as 50% of all
cardiovascular disease and as much as 50% of all cardiac admissions in many
developing countries
Pathogenesis
 MAJOR MANIFESTATIONS MINOR MANIFESTATIONS SUPPORTING EVIDENCE OF
ANTECEDENT GROUP A
STREPTOCOCCAL INFECTION

Clinical
Carditis
Manifestations
Clinical features:
and diagnosis
Positive throat culture or
rapid streptococcal antigen
test
There are 5 major and 4 minor
Polyarthritis criteria and a requirement
Arthralgia of evidence of
Elevated or increasing
recent GAS infection. streptococcal antibody titer

Erythema marginatum Fever

Subcutaneous nodules Laboratory features :
Chorea Elevated acute phase
reactants:
Erythrocyte
sedimentation rate
C-reactive protein
Treatment
Antibiotic Therapy
Antiinflammatory Therapy
Sydenham Chorea
Complications
Artritis dan korea demam rematik akut sembuh total tanpa gejala sisa.
However, the maintenance of optimal oral healthcare remains an important
component of an overall healthcare program
Prognosis
Prognosis untuk pasien dengan demam reumatik akut bergantung pada
manifestasi klinis yang ada pada saat episode awal, tingkat keparahan episode
awal, dan adanya kekambuhan.
Sekitar 50-70% pasien dengan karditis selama episode awal demam reumatik
akut sembuh tanpa penyakit jantung sisa
Prevention
Pencegahan episode demam rematik akut dan awal rekuren bergantung pada
pengendalian infeksi GAS pada saluran pernafasan bagian atas.
Individuals who have already suffered an attack of acute rheumatic fever are
particularly susceptible to recurrences of rheumatic fever with any
subsequent GAS upper respiratory tract infection, whether or not they are
symptomatic.
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