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Acute rheumatic fever

D J Burge, R J DeHoratius

    Cardiovascular Clinics
    |January 1, 1993
    PubMed
    Summary
    This summary is machine-generated.

    Rheumatic fever, a serious illness, re-emerged in the 1980s despite earlier hopes of its decline. Environmental, genetic, and group A streptococcus factors are key to understanding its epidemiology.

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    Area of Science:

    • Infectious Diseases
    • Immunology
    • Epidemiology

    Background:

    • Rheumatic fever was a prevalent disease with substantial morbidity and mortality in the U.S. during the early 20th century.
    • Renewed outbreaks in the 1980s highlighted that rheumatic fever was not eradicated and remained a significant public health concern.

    Purpose of the Study:

    • To review the current understanding of rheumatic fever's epidemiology, etiology, and clinical aspects.
    • To emphasize the need for physicians to maintain awareness of rheumatic fever as a diagnostic possibility.

    Main Methods:

    • Review of existing literature on rheumatic fever's historical prevalence, recent outbreaks, and potential contributing factors.
    • Discussion of the role of environmental, genetic, and microbial factors, specifically group A streptococcus strains and their proteins.

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  • Examination of proposed mechanisms of disease, including molecular mimicry and immune modulation by streptococci.

    • Main Results:

    • While the exact etiology remains elusive, environmental and genetic factors are recognized as significant in rheumatic fever's epidemiology.
    • Group A streptococcus, the implicated organism, exhibits strain variability, with protein differences potentially influencing its capacity to cause rheumatic fever.
    • Evidence suggests streptococci contribute antigens that cross-react with human tissues and can alter immune responses, contributing to disease pathogenesis.

    Conclusions:

    • Rheumatic fever persists as a relevant clinical diagnosis, necessitating ongoing vigilance.
    • Further research into the complex interplay of host factors and specific group A streptococcus characteristics is crucial for understanding and preventing rheumatic fever.