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Rheumatic fever

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Clinical Homeopathy (Infx diseases) Mind Map on Rheumatic fever, created by Lindie Metz on 06/03/2017.
Lindie Metz
Mind Map by Lindie Metz, updated more than 1 year ago
Lindie Metz
Created by Lindie Metz almost 9 years ago
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Resource summary

Rheumatic fever
  1. Complication d/t inadequately treated strep throat infection. Damage to heart valves is most serious complication.
    1. Description
      1. Group A Strep throat infection common with school children
        1. Most susceptible 5-8 yrs >> 15 + low healthcare, hygiene, overcrowding
        2. Cause
          1. Autoimmune response d/t similar AG of GAStrep and own cells
            1. Family tendencies – take proper hx
            2. Symptoms
              1. 1st sx = 75% arthritis >> red hot swollen shiny super painful (not symm)
                1. Ankles, knees, elbows wrists. Sens to touch, even bed sheets
                  1. Emotional instability + Sydenham's chorea/St Vitus's dance
                    1. Erythema marginatum (pink splotches
                      1. Subcutaneous nodules on knee, elbow and spine (differentiate from RA)
                        1. Pancarditis = endo/peri/myo (40-80%) >> valvular damage
                        2. Diagnosis
                          1. Also test for recent Strep infx, grow culture (24-72 hrs)
                            1. Test AB
                              1. Jones criteria
                              2. Treatment
                                1. 10 day penicillin by mouth/injection
                                  1. Regular penicillin to prevent recurrence
                                    1. Arthritis and carditis improves with anti-inflam/corticosteroids
                                      1. Chorea – diazepan >> haloperidol
                                      2. Prognosis
                                        1. Depends on case/severity of carditis – from excellent to heart failure
                                          1. Treat until FULLY healed
                                          2. Prevention
                                            1. proper dx of strep infx + 10 treatment with antibiotics
                                              1. Survivors must take preventative antibiotics before any procedure
                                                1. ALWAYS send for treatment with antibiotic and treat supportively
                                                2. FEVER
                                                  1. Aconite
                                                    1. First stage for fever and local rheumatic affections
                                                      1. red, hot, sudden, acute, sensitive, anxious
                                                      2. Bryonia
                                                        1. Fever, esp rheumatic < touch! < motion
                                                          1. Think heart – angina picture ... > lying still
                                                          2. China
                                                            1. Fever + periodicity (fever/chills/fever) + loss of bodily fluids
                                                              1. Extreme prostration, esp mind/apathy
                                                              2. Colchicum
                                                                1. old stage fever predominates + copious acid sweat [Gout]
                                                                2. Merc sol
                                                                  1. Catarrhal, RF after catching cold
                                                                  2. Nux vom
                                                                    1. RF, vertigo, chilli alt fever
                                                                      1. pains in head, back + limbs
                                                                        1. Dry skin, thirst, scanty, dark urine, delayed stool
                                                                          1. Fever app in evening, > morning, but still present
                                                                            1. Mind: irritable, aggrevated (GIT)
                                                                            2. Rhus tox
                                                                              1. After Aconite and persistent low temp, weary stiffness,, aching joints
                                                                                1. Bad effects from straining or wet weather
                                                                                  1. Limbs become lame and stiff in damp air (b4 storm)
                                                                                2. GASTRIC
                                                                                  1. Chamomilla
                                                                                    1. Gastro-RF after taking cold
                                                                                      1. Gastric complaints + V + bitter taste
                                                                                        1. OR First gastric then:
                                                                                          1. Restless ness + sleeplessness at night
                                                                                            1. tearing pains in limbs + chilliness, sour sweat, heat
                                                                                          2. JOINTS
                                                                                            1. Belladonna
                                                                                              1. Joints swollen red and shiny + streaks of red radiating from joint
                                                                                                1. RF + pains attacking nape of neck, shoulder, upper arm
                                                                                                2. Ferrum phos
                                                                                                  1. Acute articular Rh + fever
                                                                                                  2. Pulsatilla
                                                                                                    1. RF > in evening, > every other night (changeability)
                                                                                                      1. Severe pains in ankles, foot and from elbows to fingers
                                                                                                        1. dull, aching pains, ± stinging, < drinking cold water
                                                                                                      2. HEART
                                                                                                        1. Aurum metallicum
                                                                                                          1. Rheumatic endocarditis – heart always central to Aur-met
                                                                                                            1. Violent fever and swelling of joints >>> heart
                                                                                                            2. Sulphur
                                                                                                              1. Chronic RF with heart disease and mitral regurg
                                                                                                                1. quiet/passive, no swelling/redness
                                                                                                                  1. Pain on moving, afterwards < by movement

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