Carditis in Acute Rheumatic Fever in a High-Income and Moderate-Risk Country
Copyright © 2019 Elsevier Inc. All rights reserved..
OBJECTIVE: To describe clinical presentation, electrocardiographic, and echocardiographic characteristics of carditis at the time of diagnosis of acute rheumatic fever (ARF) over a 13-year period.
STUDY DESIGN: A single-center retrospective chart analysis was conducted involving all consecutive patients diagnosed with ARF between 2003 and 2015. Patient age, sex, clinical characteristics, recent medical history for group A streptococcal pharyngotonsillitis and antibiotic treatment, and laboratory, echocardiographic, and electrocardiographic findings were recorded.
RESULTS: Of 98 patients (62 boys, mean age 8.81 ± 3.04 years), 59 (60.2%) reported a positive history of pharyngotonsillitis; 48 (49%) had received antibiotic (mean duration of treatment of 5.9 ± 3.1 days), and, among these, 28 (58.3%) had carditis. Carditis was the second most frequent finding, subclinical in 27% of patients. Mitral regurgitation was present in 49 of 56 patients (87.5%) and aortic regurgitation in 36/56 (64.3%) no stenosis was documented.
CONCLUSIONS: ARF is still present in high-income countries and can develop despite primary prophylaxis, especially when given for a short course. Our findings highlight the need for 10 days of antistreptococcal treatment to prevent ARF. Echocardiography is important because 27% of cases with carditis were subclinical.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:215 |
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| Enthalten in: |
The Journal of pediatrics - 215(2019) vom: 19. Dez., Seite 187-191 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fabi, Marianna [VerfasserIn] |
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| Links: |
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| Themen: |
Acute rheumatic fever |
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| Anmerkungen: |
Date Completed 18.05.2020 Date Revised 18.05.2020 published: Print-Electronic CommentIn: J Pediatr. 2020 Jun;221:262. - PMID 32303355 Citation Status MEDLINE |
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| doi: |
10.1016/j.jpeds.2019.07.072 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM301950172 |
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| 500 | |a CommentIn: J Pediatr. 2020 Jun;221:262. - PMID 32303355 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To describe clinical presentation, electrocardiographic, and echocardiographic characteristics of carditis at the time of diagnosis of acute rheumatic fever (ARF) over a 13-year period | ||
| 520 | |a STUDY DESIGN: A single-center retrospective chart analysis was conducted involving all consecutive patients diagnosed with ARF between 2003 and 2015. Patient age, sex, clinical characteristics, recent medical history for group A streptococcal pharyngotonsillitis and antibiotic treatment, and laboratory, echocardiographic, and electrocardiographic findings were recorded | ||
| 520 | |a RESULTS: Of 98 patients (62 boys, mean age 8.81 ± 3.04 years), 59 (60.2%) reported a positive history of pharyngotonsillitis; 48 (49%) had received antibiotic (mean duration of treatment of 5.9 ± 3.1 days), and, among these, 28 (58.3%) had carditis. Carditis was the second most frequent finding, subclinical in 27% of patients. Mitral regurgitation was present in 49 of 56 patients (87.5%) and aortic regurgitation in 36/56 (64.3%) no stenosis was documented | ||
| 520 | |a CONCLUSIONS: ARF is still present in high-income countries and can develop despite primary prophylaxis, especially when given for a short course. Our findings highlight the need for 10 days of antistreptococcal treatment to prevent ARF. Echocardiography is important because 27% of cases with carditis were subclinical | ||
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| 650 | 4 | |a rheumatic carditis | |
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| 700 | 1 | |a Miniaci, Angela |e verfasserin |4 aut | |
| 700 | 1 | |a Balducci, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Tronconi, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Bonetti, Simone |e verfasserin |4 aut | |
| 700 | 1 | |a Frabboni, Ilaria |e verfasserin |4 aut | |
| 700 | 1 | |a Biagi, Carlotta |e verfasserin |4 aut | |
| 700 | 1 | |a Bronzetti, Gabriele |e verfasserin |4 aut | |
| 700 | 1 | |a Pession, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Donti, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Lanari, Marcello |e verfasserin |4 aut | |
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