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{{Rheumatic fever}}
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==Overview==
==Overview==
Rheumatic fever was first described by Hippocrates, a Greek physician, between 400-370 B.C.<ref name="pmid1775859">{{cite journal| author=Quinn RW| title=Did scarlet fever and rheumatic fever exist in Hippocrates' time? | journal=Rev Infect Dis | year= 1991 | volume= 13 | issue= 6 | pages= 1243-4 | pmid=1775859 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1775859  }} </ref> The term "rheumatic fever" was first used post-Renaissance by Guillaume de Baillou, a French physician, in the early 1600s. T. Duckett Jones, MD was the first person to publish a set of [[diagnostic]] criteria in 1944.<ref name="HIS"> THE DIAGNOSIS OF RHEUMATIC FEVER. JAMA (2015). http://jama.jamanetwork.com/article.aspx?articleid=271116 Accessed on October 9, 2015</ref>


== Historical Perspective==
== Historical Perspective==
Rheuamtic fever has been a puzzling disease for a long period and it was not until 1931 that Alvin Coburn, MD determined, for sure, that Streptococcus pyogenes infections caused its development. It was not until the 1950's that all physicians agreed that Streptococcus pyogenes was its cause. Even T. Duckett Jones, MD, the physician who first developed the Jones Criteria, did not accept the fact that Streptococcus pyogenes was the sole cause of rheumatic fever.
*Between 400-370 B.C., rheumatic fever was first described by Hippocrates, a Greek physician.<ref name="pmid1775859">{{cite journal| author=Quinn RW| title=Did scarlet fever and rheumatic fever exist in Hippocrates' time? | journal=Rev Infect Dis | year= 1991 | volume= 13 | issue= 6 | pages= 1243-4 | pmid=1775859 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1775859 }} </ref>
 
*In the early 1600s, the term "rheumatic fever" was first used post-Renaissance by Guillaume de Baillou, a French physician.
It was first thought that individuals developed an allergic response to the bacteria, but later it was determined that rheumatic fever was an autoimmunological sequela to a virulent Streptococcus pyogenes infection in a patient who had adequate rheumatic sensitivity from prior infections by Streptococcus pyogenes.  
*In the late 1600s, Thomas Sydenham described a case of severe rheumatic fever.
 
*In 1771, the term "rheumatic fever" first appeared with a description in ''Encyclopedia Britannica'''s first edition.
In north America, western Europe, Japan, much of Australia and New Zealand rheumatic fever became very uncommon. It decreased in frequency in modern western societies in a progressive fashion from the early 1900's, but it decreased remarkably after WW II so by 1970 it was thought to be a very rare disease in the USA, for instance, but it never disappeared. In certain populations such as the aboriginies of Austrialia and New Zealand it remained common and it also remained common in the aborigines of North America although it is not mentioned frequently in medical literature.   
*In the 1850s, the number of cases of rheumatic fever began to decline worldwide.  
 
*In the 1900s,  high-grade cases of rheumatic fever became less common in modernized parts of the world.<ref name="pmid25870479">{{cite journal| author=Bejiqi RA, Retkoceri R, Zeka N, Bejiqi H, Retkoceri A| title=Heart lesion after the first attack of the rheumatic Fever 22 years experience in single centre. | journal=Med Arch | year= 2015 | volume= 69 | issue= 1 | pages= 49-53 | pmid=25870479 | doi=10.5455/medarh.2015.69.49-53 | pmc=PMC4384842 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25870479  }} </ref>
More important, perhaps, are the more chronic, inflammatory, autoimmunologial disease states, which have not been well appreciated in modern times, but which were understood, at least to some degree, during prior eras. Rheumatic fever, an acute, inflammatory, autoimmune disease state was, from the mid-1600's at least, when Sydemham discribed rheumatic fever reasonably accurately, until the early 1900's was termed, often, acute rheumatism or acute articular rheumatism. The chronic disease state of rheumatic, inflammatory  autoimmunity was termed chronic rheumatism or simply, rheumatism. Galen, during the second century A.D. coined the word, rheumatismos, and it was first used in post-renaissance times by Guillaume Bailou (1538-1616)(''Rheumatic Fever and Streptococcal Infections'', cited above).           
*In World War II, conditions of over-crowding developed in military training sites and rheumatic fever became more common.  
 
*In 1944, U.S. Naval leaders hired T. Duckett Jones, MD to study rheumatic fever's [[epidemiology]] and clinical development. Dr. Jones devised certain a criteria for the [[diagnosis]] of rheumatic fever that is still in use today, albeit in a modified form.<ref>{{cite journal |author= |title=Guidelines for the diagnosis of rheumatic fever. Jones Criteria, 1992 update. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association |journal=JAMA |volume=268 |issue=15 |pages=2069-73 |year=1992 |pmid=1404745 |doi=}}</ref> The [[disease]] was not common in the United States, and usually occurs in isolated outbreaks.
The chronic non-suppurative target-organ manifestions of rheumatic fever, rheumatic heart-valve disease, is not caused by acute rheumatic fever, but it is due to a reasonably elevated, chronic, inflammatory, rheumatic, autoimmune state, which is caused by repeated, or at times chronic, infections by virulent strains of Streptococcus pyogenes. Rheumatic heart-valve disease is common in American society, but there is no outcry from treating cardiologists, and cardiac surgeons, concerning the ongoing development of the high-grade, chronic, rheumatic state within individuals in the American population.
*In the 1980s, the most recent outbreak of rheumatic fever occurred in the United States.
 
*In the present day, rheumatic fever is more common worldwide, especially in overcrowded areas.
Diagnosis of Rheumatic Fever: The diagnosis of rheumatic fever has been historically difficult, but certain physicians, since the 1500's, understood, at least in part, the complex of signs and symptoms that indicate its existence. Thomas Sydenham discribed a case of severe rheumatic fever in the late 1600's and a similar discription is provided in the Encyclopedia Britanica's first edition published in 1771: "The rheumatism chiefly attacks persons in the flower of their age, after violent exercise, or a great heat of the body from any other cause, and then being too suddenly cooled; but spares neither men nor women, old nor young...It begins with chiliness and shivering, followed by inquietude and thirst. Which is preceded with spontaneous lassitude, a heaviness of the joints, and coldness of the extreme parts. When the fever appears, there is an inward heat, chiefly about the praecordia, attended with anxiety. The pulse is quick and strait, the appetite is lost, and the body is coftive. In a day or two, sometimes sooner, the patient feels a racking pain, sometimes in one joint, sometimes in another, but more frequently in the wrists, shoulders and knees; frequently shifting from place to place, and leaving redness and swelling in the part visited last. The pain is exasperated upon the least motion; it sometimes attacks the loins and the coxendix. When it seizes the loins, it is called the lumbago; and there is a most violent pain in the small of the back, which sometimes extends to the os sacrum, and is like fit of the gravel...it may continue for months or years, but not always with the same violence, but by fits. If it continues and increases, it may cause a stiff joint, which will scarce yield to any remedy." Further,"Its proximate cause seems to be the inflammation of the lymphatic arteries." And finally, "The chronic rheumatism is either the remains of a rheumatic fever, or a continuation of pains that proceeded at first from lesser but neglected colds."
 
The above quote is very important for it specifies that since the late 1700's physicians knew that a contagion caused acute rheuamtism, also termed, a rheumatic fever, but also that it caused chronic rheumatism. At times the word, rheumatism, was used as a general term for both acute rheumatism and chronic rheumatism since certain physicians from the time of Galen knew that a respiratory disease, which caused the development of "a defluxion of rheum", phlegm (Rheum means, "to flow or to flow down" in Greek), would cause a painful systemic malady in humankind. Galen, in fact, coined the word rheumatismos about 200 AD.   
 
As rheumatic fever slowly, but progressively became less common after about 1850, as the advances of the industrial revolution were instituted into economically developed societies, especially after 1900, high-grade cases of rheumatic fever became less common in modernized parts of the world. Fewer physicians took care of patients with severe rheumatic fever so it slowly became difficult to diagnose, even in the late 1930's, by modern, western-educated physicians. One might think that physicians in modern countries have the least experience and therefore the least knowledge about rheumatic fever, however, they often have advanced knowledge about other aspects of medical science.  
 
During WW II, conditions of over-crowding developed in military training sites, and at sites of war-making activities, so rheumatic fever, as a disease entity, became more common in that environment. Leaders in the U.S. Navy Medical Corps hired T. Duckett Jones, MD, an investigator in the area of rheumatic fever, to study rheumatic fever's epidemiology and clinical development. Dr. Jones, eventually, devised certain sign and symptom criteria to provide an aid for diagnosing rheumatic fever. Those diagnostic criteria were published in the following text, (Jones,T.D., ''Journal of the American Medical Association|JAMA],'' 1944; 126:481–484) and have become known as the "Jones Criteria". They are still currently used, in a modified form, to diagnose rheumatic fever. They have been periodically revised by the [[American Heart Association]] in collaboration with other groups.<ref>[http://circ.ahajournals.org/cgi/content/full/106/19/2521?ck=nck Ferrieri P. Proceedings of the Jones criteria workshop]. ''Circulation'' 2002; 106: 2521–23</ref> '''Two major criteria, or one major and two minor criteria''', when there is also evidence of a previous strep infection, support the diagnosis of rheumatic fever.<ref>{{cite web |url=http://www.emedicine.com/emerg/topic509.htm |title=eMedicine — Rheumatic Fever | author = Steven J Parrillo, DO, FACOEP, FACEP|format= |work=}}</ref><ref>{{cite journal |author= |title=Guidelines for the diagnosis of rheumatic fever. Jones Criteria, 1992 update. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association |journal=JAMA |volume=268 |issue=15 |pages=2069-73 |year=1992 |pmid=1404745 |doi=}}</ref>
Unfortunately, since the 1930's, most physicians in modern western countries have dealt with fewer and fewer cases of rheumatic fever so at this time only the very most high-grade cases can be recognized and the symptoms and signs of those cases are what compose the "Jones Criteria". Even with the Jones Criteria having existed for decades, most cases of rheumatic fever suffer from mis-diagnosis, because most physicians simply do not think that rheumatic fever exists in modern, western countries including the USA. Out of mind out of sight is the rule.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
 
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lance Christiansen, D.O.; Anthony Gallo, B.S. [2]

Overview

Rheumatic fever was first described by Hippocrates, a Greek physician, between 400-370 B.C.[1] The term "rheumatic fever" was first used post-Renaissance by Guillaume de Baillou, a French physician, in the early 1600s. T. Duckett Jones, MD was the first person to publish a set of diagnostic criteria in 1944.[2]

Historical Perspective

  • Between 400-370 B.C., rheumatic fever was first described by Hippocrates, a Greek physician.[1]
  • In the early 1600s, the term "rheumatic fever" was first used post-Renaissance by Guillaume de Baillou, a French physician.
  • In the late 1600s, Thomas Sydenham described a case of severe rheumatic fever.
  • In 1771, the term "rheumatic fever" first appeared with a description in Encyclopedia Britannica's first edition.
  • In the 1850s, the number of cases of rheumatic fever began to decline worldwide.
  • In the 1900s, high-grade cases of rheumatic fever became less common in modernized parts of the world.[3]
  • In World War II, conditions of over-crowding developed in military training sites and rheumatic fever became more common.
  • In 1944, U.S. Naval leaders hired T. Duckett Jones, MD to study rheumatic fever's epidemiology and clinical development. Dr. Jones devised certain a criteria for the diagnosis of rheumatic fever that is still in use today, albeit in a modified form.[4] The disease was not common in the United States, and usually occurs in isolated outbreaks.
  • In the 1980s, the most recent outbreak of rheumatic fever occurred in the United States.
  • In the present day, rheumatic fever is more common worldwide, especially in overcrowded areas.

References

  1. ↑ 1.0 1.1 Quinn RW (1991). "Did scarlet fever and rheumatic fever exist in Hippocrates' time?". Rev Infect Dis. 13 (6): 1243–4. PMID 1775859.
  2. ↑ THE DIAGNOSIS OF RHEUMATIC FEVER. JAMA (2015). http://jama.jamanetwork.com/article.aspx?articleid=271116 Accessed on October 9, 2015
  3. ↑ Bejiqi RA, Retkoceri R, Zeka N, Bejiqi H, Retkoceri A (2015). "Heart lesion after the first attack of the rheumatic Fever 22 years experience in single centre". Med Arch. 69 (1): 49–53. doi:10.5455/medarh.2015.69.49-53. PMC 4384842. PMID 25870479.
  4. ↑ "Guidelines for the diagnosis of rheumatic fever. Jones Criteria, 1992 update. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association". JAMA. 268 (15): 2069–73. 1992. PMID 1404745.

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