Immunologic mulitsystem inflammatory disease following Group A β hemolytic Streptococcus( GABHS) throat infection or skin infection
If not treated in time, can progress to RHD( Rheumatic Heart Disease) with multivalvular lesions
Modified duckett jones criteria:
Major –
carditis,
Migratory polyarthritis,
chorea,
erythema marginatum,
subcutaneous nodules
Minor –
previous RHD,
arthralgia, fever,
elevated ESR,
ECG changes( PR prolongation)
Essential criteria
h/o scarlet fever or sore throat in the past
Throat swab culture positive for GABHS
2 major criteria or 1 major and 2 minor criteria should be fulfilled for diagnosis
RF Pathogenesis:
Heart valve glycoproteins cross-react with hyaluronate capsule of strep
Cross reactivity between cardiac muscle and strep cell wall M proteins
Cytotoxic T cells sensitized to strep antigens lyse heart cells
Immunoglobulins and complement attach to cardiac myocytes and Aschoff nodules are formed
“licks the joints and bites the heart”
Bacteria are themselves absent from the lesion in the heart.
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