Acute Rheumatic Fever

Land, Mack A.; Bisno, Alan L.

doi:10.1001/jama.1983.03330310025020

Cited by 116 publications

(3 citation statements)

References 10 publications

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“…found 258 out of 947 pediatric patients with a history of rheumatic fever to have rheumatic heart disease in the entire 10-year study window [ 29 ]. The estimated incidence of rheumatic fever in 1980 in the southeastern United States was 1-1.5 per 100,000 people annually, giving an estimated incidence of left atrial calcification (at 2-3%) of 0.03 per 100,000, or a total of just 63 patients with calcifications due to RF in the past 40 years in our state [ 30 ]. This is in line with estimates of rheumatic heart disease prevalence from Watkins et al .…”

Section: Discussionmentioning

confidence: 99%

Left atrial calcification on chest CT: atrial ablation replaces rheumatic heart disease as the most identified etiology

Chamberlin,

Smith,

Gowani

et al. 2023

Pol J Radiol

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PurposeLeft atrial calcification (LAC), a primarily radiologic diagnosis, has been associated with rheumatic heart disease (RHD) and rheumatic fever (RF). However, left atrial calcification continues to be observed despite a significant decrease in the prevalence of rheumatic heart disease. The purpose of this study was to investigate other possible etiologies of left atrial calcification.Material and methodsThis retrospective, observational single-center study included patients from 2017 to 2022 identified as having left atrial calcification as well as age- and sex-matched controls. The prevalence of rheumatic heart disease, atrial ablation, and mitral valve disease was compared, and odds ratios were calculated for each independent variable.ResultsSixty-two patients with left atrial calcifications were included and compared with 62 controls. 87.1% of patients in the left atrial calcifications cohort had a history of atrial fibrillation compared with 21% in the control cohort (p < 0.001). 16.1% of patients in the calcifications cohort presented a history of rheumatic fever compared with zero in the control cohort (p = 0.004). 66.1% of the left atrial calcifications cohort had a history of atrial ablation compared with 6.5% of the control group (p < 0.001). The odds ratio for left atrial calcification was 19.0 vs. 4.8 for rheumatic fever (comparative odds = 4.0 for atrial ablation vs. rheumatic fever). Multivariable log model found atrial ablation to explain 79.8% of left atrial calcifications identified.ConclusionsOur study found a 4-fold higher association between history of atrial ablation and left atrial calcification compared with rheumatic heart disease, suggesting a potential shift in etiology.

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Section: Discussionmentioning

confidence: 99%

Left atrial calcification on chest CT: atrial ablation replaces rheumatic heart disease as the most identified etiology

Chamberlin,

Smith,

Gowani

et al. 2023

Pol J Radiol

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“…Global disease burden data from the World Health Organization (WHO) place GAS as the ninth most common infectious cause of human mortality, with the majority of deaths predominantly occurring in developing nations due to invasive infections and RHD [4][5][6][7][8][9]. In the middle of the 20 th century, several studies had found a decrease in the prevalence of GAS illness in developed nations [10][11][12][13]. Although there have been numerous cases of substantial ARF [14,15].…”

Section: O Ri Gi N Al Research Art I Cl Ementioning

confidence: 99%

Antimicrobial Activity of Azithromycin and Erythromycin against Streptococcus Pyogenes Isolated from Sore Throat Patients in Shendi, Sudan

Abdelgader,

Abdo,

Mahjaf

et al. 2024

SAR J Pathol Microbiol

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Background: Streptococci is considered one of the predominant flora colonizing the respiratory tract of humans. The group A Streptococci (GAS) causes the broadest range of diseases that can lead to the asymptomatic carriage, superficial infection of the upper respiratory tract mainly throat infection. Objectives: The study was carried out to assess the antimicrobial activity of azithromycin and erythromycin against Streptococcus pyogenes (Group A) isolated from sore throat patients. Methods: Sixty-one throat swab samples from both sexes were collected randomly from different clinics in Shendi, Sudan from patients with clinical findings suggestive of throat infection between August to November 2021. Streptococcus pyogenes were isolated by standard cultural techniques and identified by using Gram stain and biochemical tests. Also, the antimicrobial activity of Azithromycin and Erythromycin were assessed using the disc diffusion method. Result: 19 throat swab samples (31%) out of 61 had S. pyogenes growth, whereas 42 (69%) did not. Of the patients, 12 (63.2% of them) were men, and 7, 36.8%, were women. The ages of the infected patients ranged from 1 to 10 years old in 2 (5.3%) cases, 11 to 20 years old in 2 (10.5%), 21 to 30 years old in 15 (78.9%), and 41 to 50 years old in 2 (5.3%) cases. In contrast to the other 5 (26.3%), 14 of them (73.7%) had recurring throat infections. Out of the 19 S. pyogenes isolates that tested positive, only 12 (63.6%) were susceptible to azithromycin and just 7 (36.8%) were resistant. 13 (68.4%) of the 19 S. pyogenes positive isolates were erythromycin sensitive, whereas 6 (31.6%) were resistant. Conclusion: Azithromycin and erythromycin are more sensitive to S. pyogenes, which indicates less excessive usage of these antibiotics in Shendi. Streptococcal infections in the respiratory tract are challenging to treat, and selecting an antibiotic treatment involves numerous considerations. Any isolated strain's susceptibility to antibiotics should be assessed because this is the only way to ensure quick and successful treatment. In order to improve public health, antibiotic therapy should be accompanied by adequate preventive measures, such as training nursing staff to prevent as many nosocomial infections as possible, educating the general public about the importance of hygiene and encouraging them to stop self-medicating and fostering closer scientific collaboration between clinicians and microbiologists.

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“…Fourteen percent of the population has genes associated with increased RHD risk [ 104 ] so that the actual probability of contracting AM/RHD is about one seventh of 1/5400, or 1/38,000. The actual incidence of RHD in the US is estimated to be between 1/25,000 and 1/100,000 [ 105 , 106 ]. Among populations in which GAS and/or CX infections are more prevalent (e.g., impoverished people), this risk would obviously increase proportionally.…”

Section: Toll-like Receptor Activation In Autoimmune Diseasementioning

confidence: 99%

Synergistic Activation of Toll-Like and NOD Receptors by Complementary Antigens as Facilitators of Autoimmune Disease: Review, Model and Novel Predictions

Root‐Bernstein

2020

IJMS

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Persistent activation of toll-like receptors (TLR) and nucleotide-binding oligomerization domain-containing proteins (NOD) in the innate immune system is one necessary driver of autoimmune disease (AD), but its mechanism remains obscure. This study compares and contrasts TLR and NOD activation profiles for four AD (autoimmune myocarditis, myasthenia gravis, multiple sclerosis and rheumatoid arthritis) and their animal models. The failure of current AD theories to explain the disparate TLR/NOD profiles in AD is reviewed and a novel model is presented that explains innate immune support of persistent chronic inflammation in terms of unique combinations of complementary AD-specific antigens stimulating synergistic TLRs and/or NODs. The potential explanatory power of the model is explored through testable, novel predictions concerning TLR- and NOD-related AD animal models and therapies.

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Acute Rheumatic Fever

Cited by 116 publications

References 10 publications

Left atrial calcification on chest CT: atrial ablation replaces rheumatic heart disease as the most identified etiology

Left atrial calcification on chest CT: atrial ablation replaces rheumatic heart disease as the most identified etiology

Antimicrobial Activity of Azithromycin and Erythromycin against Streptococcus Pyogenes Isolated from Sore Throat Patients in Shendi, Sudan

Synergistic Activation of Toll-Like and NOD Receptors by Complementary Antigens as Facilitators of Autoimmune Disease: Review, Model and Novel Predictions

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