Definition

Disease of childhood and adolescence that occurs as a result of angina due to a hemolytic Streptococcus was not cured by antibiotics.

Causes

The exact mechanism is not known with certainty. Nevertheless, we know that certain factors predispose to the occurrence of acute articular rheumatism. The young age, genetic factors (incidence in some families, ethnic groups), the socio-economic factors, the occurrence of epidemic of streptococci in school structures (colonies, schools) but also in the army, are for the occurrence of this pathology.

Symptoms

The disease occurs primarily between 7 and 15 years. 3 Years before and after 30 years is exceptional.

• Appearance of a rheumatic joint acute two to three weeks after angina, nasopharyngitis, sinusitis or which has not been processed.
• Pallor important while there is no anemia.
• Accompanied by profuse, muscle aches, chills high fever.
• Hot and painful joints.
• Increase volume of the joints.
• Regression of pain without sequelae.
• Appearance of nodules (Meynet nodules) under the skin and in the area of the affected joints (this feature is sometimes but not in all cases).
• Skin spots (papules maculo: slightly protruding spots).
• Abdominal pain frequently accompanied by of hepatomegaly (liver volume increase) or rheumatic peritonitis.

Medical analysis

The streptococcal infection is followed by a latency period during which installs antibody formation whose presence is dosable in blood.

• Search for a specific variety of proteins: antistreptolysines O (ASLO), antistreptokinases (ASK), the antihyaluronidases and the antistreptodornases. This is the increase in rates which is significant. An increase in fixed signs an old infection. The extent of these antibodies allows the therapeutic follow-up by antibiotics and corticosteroids.
• The sedimentation rate is high.
• Search for beta Streptococcus hemolytic Group A on the throat swabs.
• The liquid collected at the level of articulation is aseptic (absence of microbes): it is inflammatory type.

Treatment

•  
• Rest.
• Prolonged antibiotic (penicillin).
• Corticosteroids (cortisone use).

Prevention

Prevention of the emergence of articular rheumatism by administration of antibiotics in a subject with a red angina.