Today rheumatic fever is still the most common cause of heart disease in children and young adults in developing countries. This disease is typically associated with poverty, in particular with poor housing, overcrowding and inadequate medical care. Rheumatic fever has almost disappeared from economically developed countries; this trend has paralleled improvements in standards of living. However, the recent resurgence of rheumatic fever in middle-class families in the U. S. A. has re-emphasized the importance of this disease in the developed countries as well. Prevention and control of rheumatic fever and rheumatic heart disease is an important part of the WHO cardiovascular disease program. Based on earlier WHO experience, and on the magnitude of the problem, it was realized that concerted action was needed to combat this significant cause of cardiovascular morbidity and mortality. The present program has been developed on the principle that sound knowledge and reliable technology already exist for implementing community programs for the prevention and control of rheumatic fever and rheumatic heart disease with the intention of extending activities toward nationwide coverage. The first edition of this book was an excellent instrument to assist in the control of this disease. The present volume with dissemination of knowledge to health personnel will contribute to closing the gap between knowledge and implementation and it links with WHO's endeavors in prevention and control of rheumatic fever and rheumatic heart disease.
- Hardback | 112 pages
- 152.4 x 228.6 x 6.35mm | 310g
- 01 Oct 1990
- Kluwer Academic Publishers Group
- Kluwer Academic Publishers
- Dordrecht, Netherlands
- 2nd ed. 1989
- 112 p.
Table of contents
1 Definitions, history, and geography.- Definitions of rheumatic fever and related terms.- Brief history of rheumatic fever.- Incidence and prevalence.- Community medicine and public health importance.- 2 Etiology and epidemiology.- Streptococcal infections.- Host factors.- Environment.- 3 Pathogenesis and pathology.- Pathogenesis.- Pathology.- 4 Clinical manifestations.- Mode of onset.- Carditis.- Joint involvement.- Jaccoud's arthritis.- Chorea.- Subcutaneous nodules.- Erythema marginatum.- Other manifestations.- Duration of the rheumatic attack.- Rheumatic fever in the adult.- 5 Laboratory manifestations.- Evidence of a recent streptococcal infection.- Evidence of systemic inflammation.- Laboratory evidence of heart involvement.- 6 Diagnosis.- Jones criteria.- Critique of the criteria.- 7 Differential diagnosis.- Musculoskeletal conditions simulating rheumatic fever.- Conditions simulating chorea.- Other common diagnostic errors.- Cardiac conditions simulating rheumatic carditis and rheumatic heart disease.- 8 Treatment.- General measures and bed rest.- Antimicrobial treatment.- Analgesic and anti-inflammatory treatment.- Diuretics and cardiotonic medication.- Treatment of chorea.- 9 Sequels of rheumatic fever: chronic rheumatic heart disease.- Prognosis.- Mitral regurgitation.- Aortic regurgitation.- Mitral stenosis.- 10 Rheumatic recurrences.- Quantitative aspects.- Qualitative aspects.- 11 Prevention of recurrent attacks.- Continual parenteral prophylaxis.- Continual oral prophylaxis.- Duration of continual prophylaxis.- Obstacles to continual prophylaxis.- Mass prophylaxis.- 12 Prevention of first attacks of rheumatic fever.- Diagnosis of streptococcal pharyngitis.- Technique of taking a throat culture.- Diagnosis without a throat culture.- Treatment of streptococcal pharyngitis.- 13 Role of health care workers other than physicians in the control of rheumatic fever.- Health education.- 14 The future of rheumatic fever.- Streptococcal vaccine.- Other possible advances.- A future without vaccine.