Akut Romatizmal Ateş
Özet
Akut romatizmal ateş A grubu beta hemolitik streptokok enfeksiyonunun süpüratif olmayan komplikasyonlarından biridir. GABHS enfeksiyonu ve ARA 5-15 yaşları arasında sık görülür. GABHS tonsillofarenjitinden veya tropikal bölgelerden gelen hastalarda streptokokal piyodermadan sonraki 1-5 hafta içinde birkaç farklı klinik bulguyla ortaya çıkabilir. Amerikan Kalp Derneği tarafından 2015 yılında bildirilen modifiye Jones kriterleri ile tanı konulur. ARA’nın tedavisi antibiyotik tedavisi, anti-inflamatuvar tedavi, kalp yetmezliği yönetimi ve sekonder profilaksi ile yapılır. ARA’da prognozu belirleyen kapak tutulumunun olmasıdır. Kapak tutulumu olmayan hastalarda prognoz iyidir. Kapak tutulumunun ağırlığı ve birden fazla kapak tutulumu romatizmal kapak hastalığına ilerleme için risk faktörüdür. ARA çocuklarda morbiditesi yüksek bir hastalıktır. Önlemek için başta yaşam koşullarının iyileştirilmesi, streptokok farenjitinin uygun antibiyotikler ile önerilen sürede tedavi edilmesi ve ARA geçiren hastalarda tekrarı önlemek için uygun sürelerde sekonder profilaksi yapılması gerekmektedir.
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