Rheumatic fever and Kawasaki

• Acquired Disorders

  • Rheumatic Fever
  • Kawasaki Disease
• Acute Rheumatic Fever (ARF) Diagnosis

  1. Throat swab

  2. Blood test

  3. Jones criteria: major and minor manifestations
• Acute Rheumatic Fever (ARF) Treatment

  1. Antibiotics; NSAIDs

  2. Prevention and treatment of residual heart disease; cardiac medications, restricted activities, diuretics, low sodium diet, corticosteroids

  3. Severe Sydenham chorea: antiseizure drugs

  4. Prevention: Prevent rheumatic fever, Finish treatment, Prevent strep infection, Hand hygiene, Prophylactic antibiotic treatment prior to dental work
• Rheumatic Fever

  Complication: Rheumatic Heart Disease
• Kawasaki Disease Clinical manifestations and diagnosis

  Elevated temperature 101.3°F to 104°F (38.5°C to 40°C); Diagnosis must have elevated temperature for at least 5 days and four of the following: Cervical lymphadenopathy, Conjunctivitis (bilateral), Strawberry-colored tongue, Extremity changes, Rash on trunk, extremities, perineal area
• Kawasaki Disease Clinical manifestations

  Other manifestations: irritability, lethargy, cough, runny nose, diarrhea, vomiting, joint and abdominal pain; inflammation of arteries, veins, and capillaries, can lead to aneurysms and thrombus
• Kawasaki Disease Diagnostics

  ECG and Echocardiogram, Laboratory studies: elevated WBC count, ESR, CRP, increased platelet count
• Kawasaki Disease 3 Stages of the Disease

  Acute, Subacute, Convalescent
• Kawasaki Disease Treatment

  IV immunoglobulin (IVIG) therapy, Aspirin, Corticosteroids, Nursing care: Management of symptoms, Pain, temperature, extra fluids, passive ROM exercises, quiet environment, Family teaching: No live vaccines for 3-6 months
• Kawasaki Disease Complications

  • Aneurysms, Arrhythmias, Blood clots, Coronary arteritis, Heart valve problems, Myocarditis