风湿热

最后审阅: 19 四月 2022
最后更新: 04 二月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 发热
  • 关节痛
更多 关键诊断因素

其他诊断因素

  • 近期咽痛或猩红热
  • 胸痛
  • 呼吸短促
  • 心悸
  • 心脏杂音
  • 心包摩擦音
  • 心力衰竭的体征
  • 关节肿胀
  • 烦躁不安
  • 笨拙
  • 情绪不稳和人格改变
  • 抽动性、不协调的舞蹈样运动
  • 不能保持舌部伸出
  • 挤奶工手法
  • 匙样征
  • 旋前肌征
  • 环形红斑
  • 皮下结节
  • 妊娠或服用口服避孕药
其他诊断因素

危险因素

  • 贫穷
  • 居住拥挤
  • 风湿热家族史
  • D8/17 B 细胞抗原阳性
  • 人类白细胞抗原 (HLA) 相关性
  • 遗传易感性
  • 土著居民;澳大利亚、亚洲和太平洋岛的土著居民
更多 危险因素

诊断性检查

首要检查

  • 红细胞沉降率 (ESR)
  • C 反应蛋白 (CRP)
  • 白细胞计数
  • 血液培养
  • 心电图
  • 胸部 X 线检查
  • 超声心动图
  • 咽培养
  • A 族链球菌抗原快速检测
  • 抗链球菌血清学检查
  • 快速分子检测
更多 首要检查

治疗流程

初步治疗

未证实风湿热的单关节炎

急症处理

疑似风湿热

确诊的风湿热

持续性治疗

所有完成急性期治疗的患者

撰稿人

作者

Rachel Webb, MbChB, MPH & THM, FRACP

Senior Lecturer in Paediatrics

University of Auckland

Paediatric Infectious Diseases Specialist

Starship Children's Hospital and Middlemore Hospital

Auckland

New Zealand

利益声明

RW declares that she has no competing interests; she is an active researcher and clinician in acute rheumatic fever/rheumatic heart disease and is a co-investigator on a (non-industry) grant funded by the Health Research Council of New Zealand and gives educational talks and has prepared manuscripts on rheumatic fever solely in capacity as a University of Auckland academic and Paediatric Infectious Diseases Specialist.

鸣谢

Dr Rachel Webb would like to gratefully acknowledge Dr Andrew C. Steer and Dr Jonathan Carapetis, previous contributors to this topic.

利益声明

ACS and JC declare that they have no competing interests.

同行评议者

Salah Zaher, MD

Professor of Pediatrics

Division of Pediatric Cardiology

Faculty of Medicine

University of Alexandria

Cardiologist

El Shatby Children's Hospital

Alexandria

Egypt

利益声明

SZ declares that she has no competing interests.

Nigel Wilson, FRACP

Paediatric Cardiologist/Interventional Cardiologist

Paediatric and Congenital Cardiac Services

Green Lane Clinical Services

Starship Children's Hospital

Auckland

New Zealand

利益声明

NW declares that he has no competing interests.

Andrea Summer, MD

Assistant Professor of Pediatrics

Medical University of South Carolina

Charleston

SC

利益声明

AS declares that she has no competing interests.

  • 风湿热 images
  • 鉴别诊断

    • 化脓性关节炎
    • 青少年关节炎
    • 感染后反应性关节病
    更多 鉴别诊断
  • 指南

    • 澳大利亚急性风湿热及风湿性心脏病的预防、诊断和治疗指南(第 3 版)
    • A 族链球菌感染:指导和数据
    更多 指南
  • 患者教育信息

    风湿热

    更多 患者教育信息
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