1. "Rheumatic Fever" Ahmed Salam Lectures Medical Student “TSU”

2. G.S.M MEDICAL LECTURES/ rheumatic fever
AHMED SALAM
MD STUDENT
General idea:
Acute rheumatic fever may occur following an infection of the throat by the bacteria Streptococcus pyogenes. If it is untreated ARF occurs in up to three percent of people. The underlying mechanism is believed to involve the production of antibodies against a person's own tissues. Some people due to their genetics are more likely to get the disease when exposed to the bacteria than others. Other risk factors include malnutrition and poverty. Diagnosis of ARF is often based on the presence of signs and symptoms in combination with evidence of a recent streptococcal infection.

3. Effective organ: Brain. Synovial joint. Skin. Subcutaneous nodules.
G.S.M MEDICAL LECTURES/ rheumatic fever
AHMED SALAM
MD STUDENT
Effective organ:
Brain.
Synovial joint.
Skin.
Subcutaneous nodules.
Heart.

4. G.S.M MEDICAL LECTURES/ rheumatic fever
AHMED SALAM
MD STUDENT
Brain:
A major manifestation of acute rheumatic fever for brain, Sydenham's chorea is a result of an autoimmune response that occurs following infection by group A β-hemolytic streptococci that destroys cells in the corpus striatum of the basal ganglia. Molecular mimicry to streptococcal antigens leading to an autoantibody production against the basal ganglia has long been thought to be the main mechanism by which chorea occurs in this condition.
Sydenham's chorea (SC) or chorea minor ( Saint Vitus Dance) is a disorder characterized by rapid, uncoordinated jerking movements primarily affecting the face, hands and feet. Sydenham's chorea results from childhood infection with Group A beta-haemolytic Streptococcus and is reported to occur in 20–30% of patients with acute rheumatic fever (ARF).

5. G.S.M MEDICAL LECTURES/ rheumatic fever
AHMED SALAM
MD STUDENT
Synovial joint:
Arthritis: synovial joint Surrounded by a wall and there inside this wall fluid and inflammation gets here with pain and swelling then cause migratory polyarthritis
Arthralgias: only pain for joint.

6. Skin: G.S.M MEDICAL LECTURES/ rheumatic fever Erythema marginatum:
AHMED SALAM
MD STUDENT
Skin:
Erythema marginatum:
It occurs in less than 5% of patients with rheumatic fever'
is a type of erythema (redness of the skin or mucous membranes) involving pink rings on the torso and inner surfaces of the limbs which come and go for as long as several months. t is found primarily on extensor surfaces.

7. Subcutaneous nodules:
G.S.M MEDICAL LECTURES/ rheumatic fever
AHMED SALAM
MD STUDENT
Subcutaneous nodules:
These affect less than 5% of the patients and depending on severity, may be missed entirely.

8. Heart: G.S.M MEDICAL LECTURES/ rheumatic fever
AHMED SALAM
MD STUDENT
Heart:
Pericarditis: Under normal circumstances, the two-layered pericardial sac that surrounds your heart contains a small amount of lubricating fluid. In pericarditis, the sac becomes inflamed and the resulting friction from the inflamed sac leads to chest pain; some people with pericarditis, particularly those with long-term inflammation and chronic recurrences, can develop permanent thickening, scarring and contraction of the pericardium.

9. 2-myocarditis: G.S.M MEDICAL LECTURES/ rheumatic fever AHMED SALAM
MD STUDENT
2-myocarditis:
Aschoff bodies are specific for post rheumatic carditis, whereas Anitschkow cells can be seen in a variety of conditions. In fact, Aschoff nodules are considered pathognomonic for rheumatic heart disease; these are interstitial fibro inflammatory lesions with macrophages and collagen necrosis (see the first image below). Anitschkow cells, which have unusual wavy nuclear outlines, are called caterpillar cells and are typically present, but they can also be seen in other conditions not in association with Aschoff nodules

10. G.S.M MEDICAL LECTURES/ rheumatic fever
AHMED SALAM
MD STUDENT
3-Endocarditis:
Acute vegetations of acute rheumatic fever show valve leaflets with surface thrombi, lack of underlying valve destruction, and mild edema and chronic inflammation. Chronically, rheumatic valve disease is characterized by neovascularization, chronic inflammation, and relatively mild calcification.In contrast to annular calcification, the calcium is in the leaflet itself.