The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
Jonathan R Carapetis - One of the best experts on this subject based on the ideXlab platform.
-
Dysregulated IL-1β-GM-CSF Axis in Acute Rheumatic Fever That Is Limited by Hydroxychloroquine
Circulation, 2018Co-Authors: Man Lyang Kim, Jonathan R Carapetis, William J. Martin, Gabriela Minigo, Joanne L. Keeble, Alexandra L. Garnham, Guido Pacini, Gordon K. Smyth, Terence P. Speed, Ian P. WicksAbstract:Background: Acute Rheumatic Fever (ARF) and Rheumatic heart disease are autoimmune consequences of group A streptococcus infection and remain major causes of cardiovascular morbidity and mortality ...
-
long term outcomes from acute Rheumatic Fever and Rheumatic heart disease a data linkage and survival analysis approach
Circulation, 2016Co-Authors: John R Condon, Bart J. Currie, Anna P Ralph, Yuejen Zhao, Kathryn Roberts, Jessica L De Dassel, Marea Fittock, Keith Edwards, Jonathan R CarapetisAbstract:Background:We investigated adverse outcomes for people with acute Rheumatic Fever (ARF) and Rheumatic heart disease (RHD) and the effect of comorbidities and demographic factors on these outcomes. ...
-
acute Rheumatic Fever and Rheumatic heart disease
Nature Reviews Disease Primers, 2016Co-Authors: Jonathan R Carapetis, Luiza Guilherme, Ganesan Karthikeyan, Madeleine W. Cunningham, Bongani M Mayosi, Craig Sable, Andrea Beaton, Andrew C SteerAbstract:Acute Rheumatic Fever (ARF) is the result of an autoimmune response to pharyngitis caused by infection with group A Streptococcus. The long-term damage to cardiac valves caused by ARF, which can result from a single severe episode or from multiple recurrent episodes of the illness, is known as Rheumatic heart disease (RHD) and is a notable cause of morbidity and mortality in resource-poor settings around the world. Although our understanding of disease pathogenesis has advanced in recent years, this has not led to dramatic improvements in diagnostic approaches, which are still reliant on clinical features using the Jones Criteria, or treatment practices. Indeed, penicillin has been the mainstay of treatment for decades and there is no other treatment that has been proven to alter the likelihood or the severity of RHD after an episode of ARF. Recent advances - including the use of echocardiographic diagnosis in those with ARF and in screening for early detection of RHD, progress in developing group A streptococcal vaccines and an increased focus on the lived experience of those with RHD and the need to improve quality of life - give cause for optimism that progress will be made in coming years against this neglected disease that affects populations around the world, but is a particular issue for those living in poverty.
-
revision of the jones criteria for the diagnosis of acute Rheumatic Fever in the era of doppler echocardiography a scientific statement from the american heart association
Circulation, 2015Co-Authors: Michael H Gewitz, Jonathan R Carapetis, Stanford T Shulman, Craig Sable, Lloyd Y Tani, Kathryn A Taubert, Robert S Baltimore, Bo Remenyi, Ann F Bolger, Lee B BeermanAbstract:Background—Acute Rheumatic Fever remains a serious healthcare concern for the majority of the world’s population despite its decline in incidence in Europe and North America. The goal of this state...
-
Rheumatic Fever in indigenous australian children
Journal of Paediatrics and Child Health, 2010Co-Authors: Matthew Parnaby, Jonathan R CarapetisAbstract:Rheumatic heart disease (RHD) caused by acute Rheumatic Fever (ARF) is a disease of poverty, poor hygiene and poor living standards. RHD remains one of the major causes of childhood cardiac disease in developing nations. Within developed nations, there has been a dramatic drop in the prevalence of RHD because of the improvement of living standards, access to health care and the widespread availability of penicillin-based drugs. Despite a dramatic reduction of RHD in Australia overall, it continues to be a major contributor to childhood and adult cardiac disease in Indigenous communities throughout northern and central Australia. Currently, Australia has among the highest recorded rates of ARF and RHD in the world. The most accurate epidemiological data in Australia come from the Northern Territory's RHD control programme. In the Northern Territory, 92% of people with RHD are Indigenous, of whom 85% live in remote communities and towns. The incidence of ARF is highest in 5-14-year-olds, ranging from 150 to 380 per 100,000. Prevalence rates of RHD since 2000 have steadily increased to almost 2% of the Indigenous population in the Northern Territory, 3.2% in those aged 35-44 years. Living in remote communities is a contributing factor to ARF/RHD as well as a major barrier for adequate follow-up and care. Impediments to ARF/RHD control include the paucity of specialist services, rapid turnover of health staff, lack of knowledge of ARF/RHD by health staff, patients and communities, and the high mobility of the Indigenous population. Fortunately, the recently announced National Rheumatic Fever Strategy, comprising recurrent funding to the Northern Territory, Queensland and Western Australia for control programmes, as well as the creation of a National Coordination Unit suggest that RHD control in Australia is now a tangible prospect. For the disease to be eradicated, Australia will have to address the underpinning determinants of poverty, social and living conditions.
Bart J. Currie - One of the best experts on this subject based on the ideXlab platform.
-
Preliminary consultation on preferred product characteristics of benzathine penicillin G for secondary prophylaxis of Rheumatic Fever
Drug Delivery and Translational Research, 2016Co-Authors: Rosemary Wyber, Bart J. Currie, Joseph Kado, Ben J Boyd, Samantha Colquhoun, Mark Engel, Ganesan Karthikeyan, Mark Sullivan, Anita Saxena, Meru SheelAbstract:Rheumatic Fever is caused by an abnormal immune reaction to group A streptococcal infection. Secondary prophylaxis with antibiotics is recommended for people after their initial episode of Rheumatic Fever to prevent recurrent group A streptococcal infections, recurrences of Rheumatic Fever and progression to Rheumatic heart disease. This secondary prophylaxis must be maintained for at least a decade after the last episode of Rheumatic Fever. Benzathine penicillin G is the first line antibiotic for secondary prophylaxis, delivered intramuscularly every 2 to 4 weeks. However, adherence to recommended secondary prophylaxis regimens is a global challenge. This paper outlines a consultation with global experts in Rheumatic heart disease on the characteristics of benzathine penicillin G formulations which could be changed to improve adherence with secondary prophylaxis. Characteristics included dose interval, pain, administration mechanism, cold chain independence and cost. A sample target product profile for reformulated benzathine penicillin G is presented.
-
long term outcomes from acute Rheumatic Fever and Rheumatic heart disease a data linkage and survival analysis approach
Circulation, 2016Co-Authors: John R Condon, Bart J. Currie, Anna P Ralph, Yuejen Zhao, Kathryn Roberts, Jessica L De Dassel, Marea Fittock, Keith Edwards, Jonathan R CarapetisAbstract:Background:We investigated adverse outcomes for people with acute Rheumatic Fever (ARF) and Rheumatic heart disease (RHD) and the effect of comorbidities and demographic factors on these outcomes. ...
-
low rates of streptococcal pharyngitis and high rates of pyoderma in australian aboriginal communities where acute Rheumatic Fever is hyperendemic
Clinical Infectious Diseases, 2006Co-Authors: Malcolm I Mcdonald, Rebecca J Towers, Ross M Andrews, Norma Benger, Bart J. Currie, Jonathan R CarapetisAbstract:Background Acute Rheumatic Fever is a major cause of heart disease in Aboriginal Australians. The epidemiology differs from that observed in regions with temperate climates; streptococcal pharyngitis is reportedly rare, and pyoderma is highly prevalent. A link between pyoderma and acute Rheumatic Fever has been proposed but is yet to be proven. Group C beta-hemolytic streptococci and group G beta-hemolytic streptococci have also been also implicated in the pathogenesis. Methods Monthly, prospective surveillance of selected households was conducted in 3 remote Aboriginal communities. People were questioned about sore throat and pyoderma; swab specimens were obtained from all throats and any pyoderma lesions. Household population density was determined. Results From data collected during 531 household visits, the childhood incidence of sore throat was calculated to be 8 cases per 100 person-years, with no cases of symptomatic group A beta-hemolytic streptococci pharyngitis. The median point prevalence for throat carriage was 3.7% for group A beta-hemolytic streptococci, 0.7% for group C beta-hemolytic streptococci, and 5.1% for group G beta-hemolytic streptococci. Group A beta-hemolytic streptococci were recovered from the throats of 19.5% of children at some time during the study. There was no seasonal trend or correlation with overcrowding. Almost 40% of children had pyoderma at least once, and the prevalence was greatest during the dry season. In community 1, the prevalence of pyoderma correlated with household crowding. Group C and G beta-hemolytic streptococci were rarely recovered from pyoderma lesions. Conclusions These data are consistent with the hypothesis that recurrent skin infections immunize against throat colonization and infection. High rates of acute Rheumatic Fever were not driven by symptomatic group A beta-hemolytic streptococci throat infection. Group G and C beta-hemolytic streptococci were found in the throat but rarely in pyoderma lesions.
-
challenging perceptions of non compliance with Rheumatic Fever prophylaxis in a remote aboriginal community
The Medical Journal of Australia, 2006Co-Authors: Zinta Harrington, Bart J. Currie, David P Thomas, Joy BulkanhawuyAbstract:Aim: To identify factors that affect Rheumatic Fever prophylaxis for remote-living Aboriginal patients, and to determine the proportion who received adequate prophylaxis. Design and setting: Interview (with analysis based on principles of grounded theory) of patients with a history of Rheumatic Fever or Rheumatic heart disease and their relatives, and health service providers in a remote Aboriginal community; audit of benzathine penicillin coverage of patients with Rheumatic heart disease. Participants: 15 patients with Rheumatic heart disease or a history of Rheumatic Fever, 18 relatives and 18 health care workers. Results: Patients felt that the role of the clinic was not only to care for them physically, but that staff should also show nurturing holistic care to generate trust and treatment compliance. Differing expectations between patients and health care providers relating to the responsibility for care of patients absent from the community was a significant factor in patients missing injections. Neither a biomedical understanding of the disease nor a sense of taking responsibility for one's own health were clearly related to treatment uptake. Patients did not generally refuse injections, and 59% received adequate prophylaxis (> 75% of prescribed injections). Conclusion: In this Aboriginal community, concepts of being cared for and nurtured, MJA 2006; 184: 514–517 and belonging to a health service were important determinants of compliance.
-
acute Rheumatic Fever a chink in the chain that links the heart to the throat
The Lancet, 2004Co-Authors: Malcolm Mcdonald, Bart J. Currie, Jonathan R CarapetisAbstract:Acute Rheumatic Fever (ARF) remains a major problem in tropical regions, resource-poor countries, and minority indigenous communities. It has long been thought that group A streptococcal (GAS) pharyngitis alone was responsible for acute Rheumatic Fever; this belief has been supported by laboratory and epidemiological evidence gathered over more than 60 years, mainly in temperate climates where GAS skin infection is uncommon. GAS strains have been characterised as either rheumatogenic or nephritogenic based on phenotypic and genotypic properties. Primary prevention strategies and vaccine development have long been based on these concepts. The epidemiology of ARF in Aboriginal communities of central and northern Australia challenges this view with reported rates of ARF and Rheumatic heart disease (RHD) that are among the highest in the world. GAS throat colonisation is uncommon, however, and symptomatic GAS pharyngitis is rare; pyoderma is the major manifestation of GAS infection. Typical rheumatogenic strains do not occur. Moreover, group C and G streptococci have been shown to exchange key virulence determinants with GAS and are more commonly isolated from the throats of Aboriginal children. We suggest that GAS pyoderma and/or non-GAS infections are driving forces behind ARF in these communities and other high-incidence settings. The question needs to be resolved as a matter of urgency because current approaches to controlling ARF/RHD in Aboriginal communities have clearly been ineffective. New understanding of the pathogenesis of ARF would have an immediate effect on primary prevention strategies and vaccine development.
Kathryn A Taubert - One of the best experts on this subject based on the ideXlab platform.
-
revision of the jones criteria for the diagnosis of acute Rheumatic Fever in the era of doppler echocardiography a scientific statement from the american heart association
Circulation, 2015Co-Authors: Michael H Gewitz, Jonathan R Carapetis, Stanford T Shulman, Craig Sable, Lloyd Y Tani, Kathryn A Taubert, Robert S Baltimore, Bo Remenyi, Ann F Bolger, Lee B BeermanAbstract:Background—Acute Rheumatic Fever remains a serious healthcare concern for the majority of the world’s population despite its decline in incidence in Europe and North America. The goal of this state...
-
prevention of Rheumatic Fever and diagnosis and treatment of acute streptococcal pharyngitis a scientific statement from the american heart association Rheumatic Fever endocarditis and kawasaki disease committee of the council on cardiovascular disea
Circulation, 2009Co-Authors: Michael A Gerber, Stanford T Shulman, Anne H Rowley, Robert S Baltimore, Charles B Eaton, Michael H Gewitz, Kathryn A TaubertAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A β-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by combining clinical judgment with diagnostic test results, the criterion standard of which is the throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) is the treatment of choice, because it is cost-effective, has a narrow spectrum of activity, and has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. For penicillin-allergic individuals, acceptable alternatives include a narrow-spectrum oral cephalosporin, oral clindamycin, or various oral macrolides or azalides. The individual who has had an attack of Rheumatic Fever is at very high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The recommended duration of prophylaxis depends on the number of previous attacks, the time elapsed since the last attack, the risk of exposure to GAS infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or a macrolide or azalide are acceptable alternatives in penicillin-allergic individuals. This report updates the 1995 statement by the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee. It includes new recommendations for the diagnosis and treatment of GAS pharyngitis, as well as for the secondary prevention of Rheumatic Fever, and classifies the strength of the recommendations and level of evidence supporting them.
-
prevention of Rheumatic Fever and diagnosis and treatment of acute streptococcal pharyngitis a scientific statement from the american heart association Rheumatic Fever endocarditis and kawasaki disease committee of the council on cardiovascular disea
Circulation, 2009Co-Authors: Michael A Gerber, Stanford T Shulman, Anne H Rowley, Robert S Baltimore, Charles B Eaton, Michael H Gewitz, Kathryn A TaubertAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A beta-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by combining clinical judgment with diagnostic test results, the criterion standard of which is the throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) is the treatment of choice, because it is cost-effective, has a narrow spectrum of activity, and has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. For penicillin-allergic individuals, acceptable alternatives include a narrow-spectrum oral cephalosporin, oral clindamycin, or various oral macrolides or azalides. The individual who has had an attack of Rheumatic Fever is at very high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The recommended duration of prophylaxis depends on the number of previous attacks, the time elapsed since the last attack, the risk of exposure to GAS infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or a macrolide or azalide are acceptable alternatives in penicillin-allergic individuals. This report updates the 1995 statement by the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee. It includes new recommendations for the diagnosis and treatment of GAS pharyngitis, as well as for the secondary prevention of Rheumatic Fever, and classifies the strength of the recommendations and level of evidence supporting them.
-
prevention of Rheumatic Fever and diagnosis and treatment of acute streptococcal pharyngitis a scientific statement from the american heart association Rheumatic Fever endocarditis and kawasaki disease committee of the council on cardiovascular disea
Circulation, 2009Co-Authors: Michael A Gerber, Stanford T Shulman, Anne H Rowley, Robert S Baltimore, Charles B Eaton, Michael H Gewitz, Kathryn A TaubertAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A β-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of G...
-
treatment of acute streptococcal pharyngitis and prevention of Rheumatic Fever a statement for health professionals
Pediatrics, 1995Co-Authors: Adnan S Dajani, Patricia Ferrieri, Kathryn A Taubert, Georges Peter, Stanford T ShulmanAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A beta-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by a throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) remains the treatment of choice, because it is cost effective, has a narrow spectrum of activity, has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. Various macrolides, oral cephalosporins, and other beta-lactam agents are acceptable alternatives, particularly in penicillin-allergic individuals. The individual who has had an attack of Rheumatic Fever is at very high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The duration of prophylaxis depends on the number of previous attacks, the time lapsed since the last attack, the risk of exposure to streptococcal infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or erythromycin are acceptable alternatives in penicillin-allergic individuals. This report is an update of a 1988 statement by this committee. It expands on the previous statement, includes more recent therapeutic modalities, and makes more specific recommendations for the duration of secondary prophylaxis.
Stanford T Shulman - One of the best experts on this subject based on the ideXlab platform.
-
revision of the jones criteria for the diagnosis of acute Rheumatic Fever in the era of doppler echocardiography a scientific statement from the american heart association
Circulation, 2015Co-Authors: Michael H Gewitz, Jonathan R Carapetis, Stanford T Shulman, Craig Sable, Lloyd Y Tani, Kathryn A Taubert, Robert S Baltimore, Bo Remenyi, Ann F Bolger, Lee B BeermanAbstract:Background—Acute Rheumatic Fever remains a serious healthcare concern for the majority of the world’s population despite its decline in incidence in Europe and North America. The goal of this state...
-
macrolide treatment failure in streptococcal pharyngitis resulting in acute Rheumatic Fever
Pediatrics, 2012Co-Authors: Latania K Logan, James B Mcauley, Stanford T ShulmanAbstract:Macrolide resistance (MR) in group A Streptococcus (GAS) has been well documented in several countries and has become clinically significant since the large increases in macrolide usage during the 1970s. Macrolides are recommended as an alternative therapy for GAS pharyngitis, the most common cause of bacterial pharyngitis. Macrolide resistance has been associated with certain emm types, a sequence-based typing system of the hypervariable region of the GAS M-protein gene. Clinical failure of macrolide treatment of GAS infections can be associated with complications including acute Rheumatic Fever and Rheumatic heart disease, the leading cause of acquired heart disease in children worldwide. Here we report 2 pediatric cases of MR and/or treatment failure in the treatment of GAS pharyngitis with the subsequent development of acute Rheumatic Fever. We also review the literature on worldwide MR rates, molecular classifications, and emm types, primarily associated with GAS pharyngeal isolates between the years of 2000 and 2010. The use of macrolides in the management of GAS pharyngitis should be limited to patients with significant penicillin allergy.
-
prevention of Rheumatic Fever and diagnosis and treatment of acute streptococcal pharyngitis a scientific statement from the american heart association Rheumatic Fever endocarditis and kawasaki disease committee of the council on cardiovascular disea
Circulation, 2009Co-Authors: Michael A Gerber, Stanford T Shulman, Anne H Rowley, Robert S Baltimore, Charles B Eaton, Michael H Gewitz, Kathryn A TaubertAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A β-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by combining clinical judgment with diagnostic test results, the criterion standard of which is the throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) is the treatment of choice, because it is cost-effective, has a narrow spectrum of activity, and has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. For penicillin-allergic individuals, acceptable alternatives include a narrow-spectrum oral cephalosporin, oral clindamycin, or various oral macrolides or azalides. The individual who has had an attack of Rheumatic Fever is at very high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The recommended duration of prophylaxis depends on the number of previous attacks, the time elapsed since the last attack, the risk of exposure to GAS infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or a macrolide or azalide are acceptable alternatives in penicillin-allergic individuals. This report updates the 1995 statement by the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee. It includes new recommendations for the diagnosis and treatment of GAS pharyngitis, as well as for the secondary prevention of Rheumatic Fever, and classifies the strength of the recommendations and level of evidence supporting them.
-
prevention of Rheumatic Fever and diagnosis and treatment of acute streptococcal pharyngitis a scientific statement from the american heart association Rheumatic Fever endocarditis and kawasaki disease committee of the council on cardiovascular disea
Circulation, 2009Co-Authors: Michael A Gerber, Stanford T Shulman, Anne H Rowley, Robert S Baltimore, Charles B Eaton, Michael H Gewitz, Kathryn A TaubertAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A beta-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by combining clinical judgment with diagnostic test results, the criterion standard of which is the throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) is the treatment of choice, because it is cost-effective, has a narrow spectrum of activity, and has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. For penicillin-allergic individuals, acceptable alternatives include a narrow-spectrum oral cephalosporin, oral clindamycin, or various oral macrolides or azalides. The individual who has had an attack of Rheumatic Fever is at very high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The recommended duration of prophylaxis depends on the number of previous attacks, the time elapsed since the last attack, the risk of exposure to GAS infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or a macrolide or azalide are acceptable alternatives in penicillin-allergic individuals. This report updates the 1995 statement by the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee. It includes new recommendations for the diagnosis and treatment of GAS pharyngitis, as well as for the secondary prevention of Rheumatic Fever, and classifies the strength of the recommendations and level of evidence supporting them.
-
prevention of Rheumatic Fever and diagnosis and treatment of acute streptococcal pharyngitis a scientific statement from the american heart association Rheumatic Fever endocarditis and kawasaki disease committee of the council on cardiovascular disea
Circulation, 2009Co-Authors: Michael A Gerber, Stanford T Shulman, Anne H Rowley, Robert S Baltimore, Charles B Eaton, Michael H Gewitz, Kathryn A TaubertAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A β-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of G...
Michael A Gerber - One of the best experts on this subject based on the ideXlab platform.
-
guidance helps pediatricians distinguish between viral gas pharyngitis and prevent Rheumatic Fever
AAP News, 2009Co-Authors: Michael A GerberAbstract:An updated, AAP-endorsed statement from the American Heart Association (AHA) provides guidance for pediatricians on the prevention of Rheumatic Fever and the diagnosis and treatment of acute streptococcal pharyngitis. According to estimates from the World Health Organization, about half a million
-
prevention of Rheumatic Fever and diagnosis and treatment of acute streptococcal pharyngitis a scientific statement from the american heart association Rheumatic Fever endocarditis and kawasaki disease committee of the council on cardiovascular disea
Circulation, 2009Co-Authors: Michael A Gerber, Stanford T Shulman, Anne H Rowley, Robert S Baltimore, Charles B Eaton, Michael H Gewitz, Kathryn A TaubertAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A β-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by combining clinical judgment with diagnostic test results, the criterion standard of which is the throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) is the treatment of choice, because it is cost-effective, has a narrow spectrum of activity, and has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. For penicillin-allergic individuals, acceptable alternatives include a narrow-spectrum oral cephalosporin, oral clindamycin, or various oral macrolides or azalides. The individual who has had an attack of Rheumatic Fever is at very high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The recommended duration of prophylaxis depends on the number of previous attacks, the time elapsed since the last attack, the risk of exposure to GAS infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or a macrolide or azalide are acceptable alternatives in penicillin-allergic individuals. This report updates the 1995 statement by the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee. It includes new recommendations for the diagnosis and treatment of GAS pharyngitis, as well as for the secondary prevention of Rheumatic Fever, and classifies the strength of the recommendations and level of evidence supporting them.
-
prevention of Rheumatic Fever and diagnosis and treatment of acute streptococcal pharyngitis a scientific statement from the american heart association Rheumatic Fever endocarditis and kawasaki disease committee of the council on cardiovascular disea
Circulation, 2009Co-Authors: Michael A Gerber, Stanford T Shulman, Anne H Rowley, Robert S Baltimore, Charles B Eaton, Michael H Gewitz, Kathryn A TaubertAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A beta-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by combining clinical judgment with diagnostic test results, the criterion standard of which is the throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) is the treatment of choice, because it is cost-effective, has a narrow spectrum of activity, and has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. For penicillin-allergic individuals, acceptable alternatives include a narrow-spectrum oral cephalosporin, oral clindamycin, or various oral macrolides or azalides. The individual who has had an attack of Rheumatic Fever is at very high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The recommended duration of prophylaxis depends on the number of previous attacks, the time elapsed since the last attack, the risk of exposure to GAS infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or a macrolide or azalide are acceptable alternatives in penicillin-allergic individuals. This report updates the 1995 statement by the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee. It includes new recommendations for the diagnosis and treatment of GAS pharyngitis, as well as for the secondary prevention of Rheumatic Fever, and classifies the strength of the recommendations and level of evidence supporting them.
-
prevention of Rheumatic Fever and diagnosis and treatment of acute streptococcal pharyngitis a scientific statement from the american heart association Rheumatic Fever endocarditis and kawasaki disease committee of the council on cardiovascular disea
Circulation, 2009Co-Authors: Michael A Gerber, Stanford T Shulman, Anne H Rowley, Robert S Baltimore, Charles B Eaton, Michael H Gewitz, Kathryn A TaubertAbstract:Primary prevention of acute Rheumatic Fever is accomplished by proper identification and adequate antibiotic treatment of group A β-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of G...
-
guidelines for the diagnosis of Rheumatic Fever jones criteria updated 1992 special writing group of the committee on Rheumatic Fever endocarditis and kawasaki disease of the council on cardiovascular disease in the young american heart association
Circulation, 1993Co-Authors: Adnan S Dajani, F Z Bierman, Alan L Bisno, Floyd W Denny, David T Durack, Patricia Ferrieri, Michael D Freed, Michael A Gerber, Elia Ayoub, E L KaplanAbstract:The Jones criteria for guidance in the diagnosis of acute Rheumatic Fever were first published by T. Duckett Jones, MD, in 1944 and have been revised over the years by the American Heart Association. The current guidelines are an update of these criteria. For the first time, the guidelines are designed to establish the initial attack of acute Rheumatic Fever. Major manifestations, minor manifestations, and supporting evidence of antecedent group A streptococcal infection are discussed. These updated guidelines expand on the available tools to diagnose streptococcal pharyngitis and clarify the available antibody tests for detecting antecedent group A streptococcal infection. At the present time echocardiography without accompanying auscultatory findings is insufficient to be the sole criterion for valvulitis in acute Rheumatic Fever. Finally, this article addresses overdiagnosis of Rheumatic Fever and lists exceptions to the Jones criteria, including recurrent attacks in individuals with a history of Rheumatic Fever.
