David L
Département de pédiatrie, Hôpital Edouard-Herriot, Lyon, France.
Arch Pediatr. 1998 Jun;5(6):681-6. doi: 10.1016/s0929-693x(98)80179-6.
Rheumatic fever has become rare in France as in most developed countries. However, recent outbreaks have underlined the need for practitioners to remain vigilant and to maintain careful prevention. Polyarthritis and polyarthralgia are the main manifestations of rheumatic fever but they are not specific. Carditis is a major feature which affects only half the patients; cardiac ultrasonography is therefore very helpful with respect to positive and false positive diagnoses resulting from innocent murmurs. Fever, acute phase inflammatory markers, and evidence of streptococcal infection are of major importance and rheumatic fever must be disregarded in their absence. The treatment includes: 1) steroids for a 3 month-period; 2) early antibiotic treatment of streptococcal carriage; 3) long-term prophylaxis using intramuscular benzathine penicillin.
与大多数发达国家一样，风湿热在法国已变得罕见。然而，近期的疫情凸显了从业者保持警惕并进行仔细预防的必要性。多关节炎和多关节痛是风湿热的主要表现，但并不具有特异性。心脏炎是一个主要特征，仅影响一半的患者；因此，心脏超声检查对于由无害杂音导致的阳性和假阳性诊断非常有帮助。发热、急性期炎症标志物以及链球菌感染的证据至关重要，若无这些则必须排除风湿热。治疗包括：1）为期3个月的类固醇治疗；2）对链球菌携带进行早期抗生素治疗；3）使用苄星青霉素肌肉注射进行长期预防。
