Merino Muñoz R, Viota Losada F, Sancho Madrid B, Castro Gussoni C, García-Consuegra Molina J
Unidad de Reumatología Pediátrica, Hospital Infantil La Paz, Madrid.
An Esp Pediatr. 1991 Oct;35(4):239-42.
We report 11 patients diagnosed of Acute Rheumatic Fever (ARF), and 7 of Poststreptococcal Reactive Arthritis (PSRA): patients with group A beta hemolytic streptococcal infection and articular disease who do not fulfill the modified Jones criteria. All patients with ARF were treated with monthly prophylaxis (with penicillin G benzathine). Carditis was seen in five patients, but only one of them has developed a mitral valve insufficiency. The prophylaxis in patients with PSRA was individualized. None of these patients had clinical evidence of carditis during the acute disease, but one of them developed a mitral and aortic stenosis two years after the initial episode. The possible indication of penicillin prophylaxis in these patients with PSRA in suggested.
我们报告了11例被诊断为急性风湿热(ARF)的患者和7例链球菌感染后反应性关节炎(PSRA)的患者:这些患者均患有A组β溶血性链球菌感染及关节疾病,但不符合改良琼斯标准。所有ARF患者均接受每月一次的预防性治疗(使用苄星青霉素G)。5例患者出现心脏炎,但其中只有1例发展为二尖瓣关闭不全。PSRA患者的预防性治疗是个体化的。这些患者在急性期均无心脏炎的临床证据,但其中1例在初次发作两年后发展为二尖瓣和主动脉瓣狭窄。本文提出了在这些PSRA患者中使用青霉素进行预防性治疗的可能性。