Diagnosis of rheumatic fever

The diagnosis of rheumatic fever is on the basis of clinical signs characteristic lesions of one or more organs (heart, joints, skin, Nervous system and other) and laboratory results. Blood for acute phase of rheumatism characteristic neutrophilic leucocytosis to 12 000 - 15 000, with a shift to the left. With sluggish for rheumatism white blood cells may be normal or even lowered; sometimes there eosinophilia. ROHE in active rheumatic process, generally faster, sometimes up to 50-70 mm per hour. The amount of hemoglobin in the beginning of the disease can be reduced; with frequent recurrences of rheumatic fever develops anemia. Change protein fractions of blood: increases the amount of globulin, you receive the so-called C-reactive protein. In the blood increases the content of fibrinogen, seromucoid; positive difenilamina reaction (DFA). There has been an increasing titers of streptococcal antibodies (antistreptolysine, antistreptokinase, antistreptokinase). In the diagnosis of rheumatic heart disease helps electrocardiography (see) and phonocardiography (see Ponografia).
ECG often find lower voltage, violations conductivity, extrasystoles (see heart Arrhythmia). On phonocardiogram marked change in tone of the heart, the noise. Depending on clinical and laboratory data distinguish between active and inactive phase rheumatism; with the active process there are three degrees of activity: 1) the Rheumatism with the maximum activity (III degree) - sharp, continuous recurrent; 2) Rheumatism with moderate activity (II degree) - subacute; 3) Rheumatism with minimal activity (I degree) - weak current or latent.
Differential diagnosis. Rheumatism should be differentiated from non-infectious arthritis, tuberculosis, septic endocarditis, thyrotoxicosis, neurosis and other
Forecast for rheumatism depends on the age of the patient, primary localization of rheumatic lesions, the severity of heart failure. Prognosis worsens, if the disease starts in pre-school age and occurs with frequent relapses. Currently, in connection with the improvement of methods of diagnostics, treatment and prophylaxis of rheumatic fever has improved the forecast, decrease the number of relapses, decreased the percentage of disability and mortality.

  • The clinical picture of rheumatoid arthritis
  • Treatment and prophylaxis of rheumatic fever
  • Rheumatic fever in children