In the diagnosis of rheumatic fever in children

In the diagnosis of acute rheumatic fever rely mainly on clinical manifestations. Due to the lack of special diagnostic methods, in the past often divided into rheumatic fever five major clinical indications and six minor indications. There are two main levy or indications of a major with two minor indications, the diagnosis can be established. Main indications including myocarditis, multiple arthritis, chorea, subcutaneous nodules and annular erythema. Secondary indications including fever, joint pain, past or present history of rheumatic fever have a rheumatic heart disease, erythrocyte sedimentation rate or C-reactive protein growth positive, increasing the total number of leukocytes, ECG PR interval prolongation. If the recently had hemolytic streptococcus infection is even more evidence to support the diagnosis. Early rheumatic fever, if the symptoms are not typical light, or require a comprehensive understanding of history, and closely observe the changes of the disease and response to treatment, and comprehensive analysis can be done after diagnosis. Especially if fever, joint and muscle pain, abdominal pain, epistaxis, accelerated heart rate, Antistreptolysin-"O" titration of increased, and so on, may be caused by rheumatic fever, but is also entirely possible, or other streptococcal infection reasons, we must consider seriously order to prevent missed or misdiagnosed. Rheumatic fever is still determining whether activities can be based on the following general areas: 1. Any clinical symptoms of rheumatic fever symptoms indicated the existence of the existence of rheumatoid activities. Children suffering from rheumatic fever, if the performance was pale, weak, not by weight, and phenomena such as tachycardia, often suggested that the continued presence of rheumatoid activities. 2. Laboratory tests had been Although the clinical symptoms disappeared, but ESR are on the increase quickly, mucin increase the total number of leukocytes and increased accounted for no other reason, we have to consider the existence of rheumatoid activities. 3. ECG diagnosis for children with rheumatic fever, PR interval extension of the continuing, and often tips are still heart inflammation. In addition diagnosis when the distinction should be drawn between the early and re-issued. Refers to the beginning of the first rheumatoid activities, the majority after treatment 1 ~ 6 months cure rheumatism and stop activities, and some patients with recurrent, rheumatoid activities and performance relative to stationary alternating, and often stop in a relatively stationary ~ 2 months after emerging rheumatoid activities, such as the development of children with heart-valve disease; refers to the clinical and laboratory tests confirmed rheumatoid no more than three months and has been re-incidence. This division of prevention, treatment and prognosis are of significance, therefore, the beginning of the children should be given great attention, a thorough treatment.