ACUTE RHEUMATIC FEVER: CLINICAL AND DIAGNOSTIC ASPECTS AT THE PRESENT STAGE

Аннотация

Today, despite advances in treatment and prevention, the issue of acute rheumatic fever (ARF) remains relevant among pediatricians and otolaryngologists. Rheumatic carditis, complicated by ARF, is considered the primary reason for hospitalizations in cardiology departments for patients aged 5 to 24 years. Globally, according to WHO statistics, approximately 500 thousand people contract rheumatic fever each year, with 300 thousand of them developing ARF, leading to heart defects. These complications constitute the primary cause of disability. As indicated by foreign literature sources, the etiology of ARF development is Group A Streptococcus (GAS). Unfortunately, the epidemiology of this infection has changed significantly in recent years. The outdated term "rheumatism," traditionally associated with rheumatology, has fallen out of use. Instead, we now employ the term "acute rheumatic fever," as per the classification, which is more justified. Using the term acute rheumatic fever prompts the physician to clarify the role of GABHS infection in this pathology, emphasizing the need for prescribing antibiotics to eradicate the pathogen during the acute period (primary prevention) and prevent recurrent episodes (secondary prevention). According to the ICD-X revision (WHO, Geneva, 1995), ARF falls under class IX, "diseases of the circulatory system," specifically under headings I00 and I05 as independent disease groups, identified as distinct nosological forms. This classification appears justified concerning treatment strategies for patients and in supporting primary and secondary prevention efforts.