De Cunto C L, Giannini E H, Fink C W, Brewer E J, Person D A
Department of Pediatrics, Baylor College of Medicine, Houston, TX.
Pediatr Infect Dis J. 1988 Oct;7(10):683-6. doi: 10.1097/00006454-198810000-00002.
Patients with Group A beta-hemolytic streptococcal infection and articular disease who do not fulfill the modified Jones criteria for a diagnosis of acute rheumatic fever (ARF) have been classified as poststreptococcal reactive arthritis/arthralgia. We reviewed the initial clinical characteristics and outcome of 12 poststreptococcal reactive arthritis/arthralgia patients. During the initial episode all had arthritis or arthralgia and a documented streptococcal infection. None had carditis and none received prophylactic antibiotic therapy during an average follow-up of 17 months (range, 6 to 42 months). One patient developed classic ARF with valvulitis 18 months after the initial episode. Two children had later episodes of arthritis and two had at least one additional episode of arthralgia. Poststreptococcal reactive arthritis/arthralgias seems to be part of the disease spectrum of ARF and therefore the use of prophylactic antibiotic therapy to prevent subsequent development of ARF and carditis in these patients should, perhaps, be reconsidered.
患有A组β溶血性链球菌感染和关节疾病但不符合急性风湿热（ARF）诊断的改良琼斯标准的患者，已被归类为链球菌感染后反应性关节炎/关节痛。我们回顾了12例链球菌感染后反应性关节炎/关节痛患者的初始临床特征和结局。在初始发作期间，所有患者均有关节炎或关节痛并有记录的链球菌感染。无人患心肌炎，在平均17个月（范围6至42个月）的随访期间无人接受预防性抗生素治疗。1例患者在初始发作18个月后出现伴有瓣膜炎的典型ARF。2名儿童后来出现关节炎发作，2名儿童至少有1次额外的关节痛发作。链球菌感染后反应性关节炎/关节痛似乎是ARF疾病谱的一部分，因此，或许应重新考虑在这些患者中使用预防性抗生素治疗以预防ARF和心肌炎的后续发展。
