Acute rheumatic fever

Fever is defined by specialists as a protective-adaptive reaction. Thus, the body responds to the effects of pathogenic (harmful, pathogenic) factors. These include bacteria, viruses, immune complexes and others). The most important manifestation of fever is the restructuring of thermoregulation. As a result, higher levels of heat content and a higher body temperature are maintained.

Acute rheumatic fever is a systemic disease. This pathology is inflammatory in nature and affects the connective tissue. Acute rheumatic fever, as a rule, develops in people with a genetic predisposition after two or four weeks after the transfer of streptococcal infection (often angina). The causative agent in this case is the beta-hemolytic microorganism of group A.

Acute rheumatic fever and chronic rheumatic heart disease are combined under the widely used term "rheumatism".

The influence of genetic predisposition is clearly demonstrated by the high prevalence of pathology in individual families.

Acute rheumatic fever develops under the influence of several mechanisms. Certain value may have damage to toxic elements of the myocardium. The pathogenic influence is exerted by cardiotropic enzymes of streptococcus (beta-hemolytic) A-group. However, a special role is assigned to the development of humoral and cellular immune responses.

Rheumatism includes four stages of the course of the pathological process involving connective tissue:

1. Mucoid swelling.

2. Fibrinoid changes are a stage of disorganization in connective tissue of an irreversible nature.

3. Proliferative reactions. As a result of proliferation (neoplasm) of cells and tissue necrosis , Ashot-Talalayeva granulomas are formed. They consist of large basophilic elementary units, irregular in shape. The granulomas also include plasma and lymphoid, as well as giant multinucleated cells with eosinophilic cytoplasm of myocyte origin. They are located, as a rule, in the endocardium, myocardium, perivascular heart connective tissue.

4. Sclerosis.

The nature of the course of pathology has a close relationship with the age of patients. Acute rheumatic fever in children in more than half the cases develops after two to three weeks after the transferred angina. There is a sudden increase in body temperature, the development of migrating (asymmetric) pain in the large joints (usually knee), and signs of carditis (dyspnea, pericardial pain in the chest, palpitation, etc.). In other patients monosymptomatic flow is observed. In this case, the signs of carditis or arthritis predominate.

For adolescents and patients at a young age is characterized by (after alleviating the clinical manifestations of angina) a gradual onset - with arthralgia of large joints, subfebrile temperature or moderate carditis symptoms. Relapse (re-development) of rheumatic fever in almost all cases is associated with a transmitted infection (streptococcal) and is manifested by the development of carditis predominantly.

As a rule, the cause of fever becomes clear on the background of the appearance of symptoms of one or another infection. In many cases, the condition stabilizes on its own. However, the acute fever of unclear etiology presupposes the doctor's increased attention, including a multiple examination of the patient (especially the child). Regular examination will allow to diagnose in a timely manner the symptoms of a serious illness or the development of a threatening condition.