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Rheumatic fever and disorders of the musculoskeletal system
1University of Natal Medical School, Durban, Congella, South Africa.
Abstract:
New information provided on the pathogenesis and management of rheumatic fever is of current interest. Invasive disease by group A streptococci has been shown to be due to production of toxin A. The natural history and immunopathologic basis for chronic Lyme arthritis are reported. Attention is drawn to pyomyositis and clinical presentation of chronic fatigue syndrome in children. Patients with Sweet's syndrome often have antineutrophil cytoplasmic autoantibodies. Biopsy specimens of panniculitis should be taken to aid treatment. Long-term outcome in chronic osteomyelitis is favorable; recommendations on the rational use of imaging have been reported.
Insights
This review covers rheumatic fever pathogenesis, group A streptococcal toxin A, Lyme arthritis, pyomyositis, chronic fatigue syndrome, Sweet's syndrome, panniculitis, and osteomyelitis management. It offers insights into various infectious and autoimmune conditions affecting children and adults.
Area of Science:
- Rheumatology
- Infectious Diseases
- Immunology
Background:
- Rheumatic fever pathogenesis and management are of significant current interest.
- Invasive group A streptococcal disease is linked to toxin A production.
- Chronic Lyme arthritis has a specific natural history and immunopathologic basis.
Purpose of the Study:
- To provide updated information on the pathogenesis and management of rheumatic fever.
- To report on the natural history and immunopathologic basis of chronic Lyme arthritis.
- To discuss pyomyositis, chronic fatigue syndrome in children, Sweet's syndrome, panniculitis, and chronic osteomyelitis.
Main Methods:
- Review of current literature on streptococcal infections, Lyme disease, and inflammatory conditions.
- Analysis of clinical presentations and diagnostic findings for various rheumatologic and infectious diseases.
- Evaluation of treatment strategies and long-term outcomes for chronic osteomyelitis.
Main Results:
- Group A streptococcal invasive disease is associated with toxin A.
- Chronic Lyme arthritis has a defined immunopathologic basis.
- Biopsy is recommended for diagnosing panniculitis.
- Long-term outcomes for chronic osteomyelitis are generally favorable.
Conclusions:
- Updated understanding of rheumatic fever pathogenesis and management is crucial.
- Recognition of specific causative agents and immunologic factors is key for conditions like Lyme arthritis.
- Rational use of imaging and diagnostic procedures like biopsy aids in managing complex rheumatologic and infectious diseases.