Rheumatic Fever In Adults Research Articles

Acute rheumatic fever in adults: case report together with an analysis of 25 patients with acute rheumatic fever

We reported the oldest acute rheumatic fever (ARF) patient with initial attack at the age of 90 years and experience with ARF in adults in 20 years of observation. The case files of all ARF patients treated by rheumatology unit, Chiang Mai University, were reviewed. Demographic data and clinical profile were recorded and compared between patients with initial attack and patients with recurrent attack. A total of 25 patients with ARF were included. There was no different incidence of arthritis and carditis between two groups. Initial attack patients have higher incidence of prolonged PR-interval (67 vs. 12%, P = 0.049) and longer duration of admission to diagnosis (5 vs. 2 days, P = 0.05). Thirty percent presented initial attack after 30 years of age. ARF is more common in adults than previously recognized. Therefore, clinicians should be aware of this condition and include it in their differential diagnosis of the febrile patients with arthritis.

Beta haemolytic streptococci and reactive arthritis in adults.

There is an increasing occurrence of reactive group A beta haemolytic streptococci (BHS) phenomena. This review makes a case for considering BHS in the differential diagnosis of adult reactive arthritis. This is based on (a) published reports over the past 45 years describing first attacks of rheumatic fever in adults; (b) the longstanding observation that polyarthritis is the most commonly expressed Jones major criterion in adults; (c) the broad spectrum of clinical expression of disease following streptococcal infection, with the re-emergence of the term 'poststreptococcal reactive arthritis'. The arthritis in adult rheumatic fever is characterised by sequential involvement of large weightbearing joints. Recurrent, severe, prolonged arthritis has been a prominent feature of adult poststreptococcal reactive arthritis. Carditis has been reported in 33% of adult patients with rheumatic fever. Consequently long term antibiotic prophylaxis for adults with reactive BHS phenomena should be strongly considered, and guidelines are suggested for this in individual patients. Further areas for research are discussed, particularly the interrelations between bacteria and host in disease expression, and the possibility that BHS might play a part in chronic arthritides and vasculitides.

The Collaborative Clinical Study on Acute Rheumatic Fever in Adults from 27 Referral Hospitals in Korea

The Collaborative Clinical Study on Acute Rheumatic Fever in Adults from 27 Referral Hospitals in Korea

About five cases of acute rheumatic fever in the adult.

We describe five cases of acute rheumatic fever in adults (applying Jones's criteria and exclusion of other common causes of acute polyarthritis in adults). The polyarthritis was migratory in three patients and additive in two. Severe tenosynovitis was present in three patients. Only one patient had carditis and received corticoids. The others improved with aspirin. The disease subsided after a time period varying from one week to two months and did not relapse.

Rheumatic Fever in Adults

Excerpt To the editor: We read with interest the article by McDanald and Weisman in the December 1978 issue (1) on articular manifestations of rheumatic fever in adults. During our early medical tr...

Rheumatic Fever in Adults

Excerpt To the editor: I have read with great interest the article in the December 1978 issue on acute rheumatic fever in adults (1) and wish to add two cases to those presented. In the last 5 mont...

Rheumatic Fever and Gonococcal Pharyngitis in an Adult

The arthritis of rheumatic fever in adults may mimic acute gonococcal arthritis. To further characterize this clinical picture the features of six patients presenting with the migratory polyarthritis of acute rheumatic fever have been analyzed. There were two men and four women, ranging in age from 18 to 43; in five the initial clinical impression was gonococcal arthritis. In all patients, however, the diagnosis of acute rheumatic fever was subsequently established. Characteristics of acute rheumatic fever not commonly described included tenosynovitis in all six and an erythematous rash in three. In three patients synovial fluid WBC exceeded 28,000/cu mm, with greater than 90% neutrophils. In five of the six, gonococcal arthritis was ruled out by appropriate studies and by failure to respond to antibiotics in all patients. The one patient with serum antigonococcal antibodies had gonococcal pharyngitis and acute rheumatic fever.

Articular manifestations of rheumatic fever in adults.

Six adult patients had a syndrome indistinguishable from childhood rheumatic fever, with few cardiac findings and an arthrutis that had a characteristic pattern. The joint disease was abrupt in onset, rapidly additive, and eventually symmetrical, with a lower-extremity, large-joint predominance and a profoundly symptomatic tenosynovitis. Emphasizing the benign prognosis associated with a lack of heart disease and a "typical" pattern of articular involvement, we have reassessed the sensitivity of the traditional diagnostic Jones' criteria and suggest that this syndrome in adults may be more properly termed "poststreptococcal arthritis."

Acute rheumatic fever in adults

Acute rheumatic fever (ARF) in 53 adults was characterized by a severe, febrile migratory polyarthritis involving primarily large joints in the lower extremities, with evidence of an antecedent streptococcal infection. Carditis, present in only eight (15%) of the adults, was mild and transient. The characteristic abnormality in laboratory findings was an erythrocyte sedimentation rate (Westergren) greater than 100 mm/hr. Response to high-dose aspirin therapy was prompt and dramatic in all patients. Mild and evanescent abnormalities of both renal function and hepatic function (not aspirin-mediated) were detected in 51% and 64%, respectively. A common disorder in San Antonio, ARF has distinctive symptoms. It can be readily diagnosed and promptly treated. In the adult, it is almost exclusively a syndrome of events severe but transient in the joints, and mild and transient in the heart, kidneys, and liver. (<i>JAMA</i>232:925-928, 1975)

Acute Rheumatic Fever in Adults

Acute rheumatic fever (ARF) in 53 adults was characterized by a severe, febrile migratory polyarthritis involving primarily large joints in the lower extremities, with evidence of an antecedent streptococcal infection. Carditis, present in only eight (15%) of the adults, was mild and transient. The characteristic abnormality in laboratory findings was an erythrocyte sedimentation rate (Westergren) greater than 100 mm/hr. Response to high-dose aspirin therapy was prompt and dramatic in all patients. Mild andevanescent abnormalities of both renal function and hepatic function (not aspirin-mediated) were detected in 51% and 64%, respectively. A common disorder in San Antonio, ARF has distinctive symptoms. It can be readily diagnosed and promptly treated. In the adult, it is almost exclusively a syndrome of events severe but transient in the joints, and mild and transient in the heart, kidneys, and liver.

A Community-Wide Study of Acute Rheumatic Fever in Adults

In Baltimore from 1960 to 1964, 18% of all patients hospitalized for acute rheumatic fever were adults. The average annual incidence of hospitalizations for acute rheumatic fever in adults aged 20 to 39 years was 3.1 per 100,000, approximately one fifth the rate in children and adolescents in the same community. Incidence rates were higher among nonwhites than whites, particularly for recurrent attacks. None of the adults with a recurrence was receiving regular prophylaxis at the time of his attack. Seven of the 12 patients with recurrences had no history of clinical symptoms relating to prior upperrespiratory tract infection. The data indicate that both initial and recurrent attacks of acute rheumatic fever continue to occur in adults, and emphasize the importance of maintaining continuous antistreptococcal prophylaxis in the young adult rheumatic population.

A community-wide study of acute rheumatic fever in adults. Epidemiologic and preventive factors

A community-wide study of acute rheumatic fever in adults. Epidemiologic and preventive factors

Acute rheumatic fever in adults

Acute rheumatic fever in adults

Sequelae of rheumatic fever in men: four to eight year follow-up study.

Although the natural history of rheumatic fever in children is well documented, the literature contains few such studies of the disease in adults. 1 Knowledge of the course and late effects of rheumatic fever in adults could be of value for comparison with other studies in evaluating the results of new methods of treatment; in establishing physical standards for selection and utilization of men for military service; and in determining candidacy for discharge from the armed forces once the disease has occurred. The present report is based on a study of male veterans of World War II who had had an attack of rheumatic fever during military service and who were observed four to eight years after that attack. In evaluating the sequelae of rheumatic fever in our series of veterans, the following aims were considered important: (1) to determine to what extent rheumatic heart disease is a sequel to

The Clinical Aspects of Rheumatic Fever in Adults

RHEUMATIC fever has been generally regarded as a disease principally affecting children, and its occurrence in adults has as a consequence been more or less ignored. The high incidence of this disease among members of the armed forces has, however, served to focus attention on its importance in older persons, particularly young adults. It is the purpose of this paper to present a composite picture of the clinical aspects of rheumatic fever as observed in a series of 1000 patients studied at a large naval hospital.EtiologyAlthough the etiology of rheumatic fever remains unknown, epidemiologic studies indicate that there . . .

Clinical aspects of rheumatic fever in adults: Roth, Irving R.: Bull. New York Acad. Med. 16: 514, 1940

Clinical aspects of rheumatic fever in adults: Roth, Irving R.: Bull. New York Acad. Med. 16: 514, 1940

POLYARTHRITIS. REPORT OF A CASE IN AN INFANT SIX DAYS OLD

Nonsuppurative arthritis similar to acute rheumatic fever in adults is rarely found in children under 1 year of age. 1 Miller 2 reported twenty authentic cases, one of his own and nineteen from the literature up to 1899. He differentiated rheumatic fever as an acute migratory polyarthritis, nonsuppurative in type. Since 1899, single cases have been reported. Del Arca, 3 Griffith. 4 and Stromme 5 include three cases in their descriptions, the children ranging in age from 6 to 8 months. In the majority of cases reported, recovery took place in from several weeks to several months. The etiology of the disease is not clear. though in a few cases the arthritis occurred in the infant soon after birth, following acute rheumatic fever in the mother during the latter part of pregnancy. This sequence of the disease in the mother and child is exceedingly rare. 6 Pocock 7 in 1882,