Walker Kathleen G, de Vries Petrus J, Stein Dan J, Wilmshurst Jo M
Department of Pediatric Neurology, Red Cross War Memorial Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa Rheumatic Fever Clinic, Red Cross War Memorial Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa.
J Child Neurol. 2015 Jun;30(7):850-9. doi: 10.1177/0883073814544704. Epub 2014 Sep 16.
In South Africa, and worldwide, rheumatic fever represents a public health problem. Improved diagnosis and management of Sydenham chorea, a major manifestation of acute rheumatic fever is key to prevention of rheumatic heart disease. This article reviews Sydenham chorea from its original description to current opinions. Recommendations are founded on expert opinion as class 1 data is lacking. This South African perspective is relevant to resource-poor settings globally insofar as it provides diagnosis and management recommendations for primary- and secondary-level healthcare professionals who care for patients in such environments. Four basic tenets of care are recommended, namely, elimination of the streptococcal infection, symptomatic treatment, immunological treatment, and nonpharmacologic interventions. A user-friendly outcome measurement tool, viable for use in low-resource settings is presented. Introduction of this tool may lead to increased awareness of the neuropsychiatric manifestations of poststreptococcal movement disorders in Africa, where reports are limited.
在南非乃至全球，风湿热都是一个公共卫生问题。改善对急性风湿热的主要表现之一—— Sydenham 舞蹈病的诊断和管理是预防风湿性心脏病的关键。本文回顾了Sydenham舞蹈病从最初描述到当前观点的情况。由于缺乏1类数据，建议基于专家意见。这种南非视角与全球资源匮乏地区相关，因为它为在这种环境中照顾患者的初级和二级医疗保健专业人员提供了诊断和管理建议。推荐了四项基本护理原则，即消除链球菌感染、对症治疗、免疫治疗和非药物干预。还介绍了一种便于使用的结果测量工具，适用于资源匮乏地区。引入该工具可能会提高非洲对链球菌感染后运动障碍神经精神表现的认识，目前非洲关于这方面的报告有限。
