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在年轻人中,急性类风湿性发烧的复发
M R Wallace1, P D Garst, T J Papadimos
1Department of Internal Medicine (Infectious Disease Division), Naval Hospital, San Diego, Calif.
JAMA
|November 10, 1989
概括
在美国,急性风湿性发烧 (ARF) 正在重新出现,最近在新兵中爆发了疫情. 成人发病的ARF呈现严重,强调需要更广泛的临床怀疑超越儿童.
科学领域:
- 类风湿病学 类风湿病学
- 传染病流行病学 传染病流行病学
- 公共卫生 公共卫生
背景情况:
- 在过去的30年里,急性类风湿性发烧 (ARF) 发病率在美国显著下降.
- 最近分散的疫情表明,ARF在美国学童中可能会复苏.
- 一个值得注意的ARF病例集群发生在成年军人新兵中,标志着一个重要的事件.
研究的目的:
- 在接受军事基础训练的年轻成年男性中报告ARF病例的独特集群.
- 描述这个队列中成人发病的ARF的临床表现和严重程度.
- 重新出现的ARF作为北美潜在的公共卫生问题.
主要方法:
- 对10名被诊断患有ARF的患者进行了回顾性病例系列分析.
- 临床数据收集包括症状,病史和诊断发现.
- 对疫情爆发环境的流行病学调查.
主要成果:
- 在圣地亚哥的军人新兵中发现了一组10例ARF病例.
- 这是20多年来首次在军事人员中爆发疫情,也是10多年来大批成年病例的首次爆发.
- 心炎发生在30%的患者中,类似于成年人ARF历史的发病率. 所有患者都患有严重的多关节炎,贫血和发烧. 只有60%的人报告了之前的喉炎.
结论:
- 成人发病的ARF可能是严重的,心脏炎的发病率很高.
- 成年人中的ARF的临床表现可能会有所不同,之前发炎的发病率较低.
- 医疗保健提供者应在患有多关节炎的成年人中保持对类风湿性发烧的高度怀疑指数,无论他们有过喉疼痛史.
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