Larry
Forum Newbie
Topics: 8
Posts: 21
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Hi, my fellow step 2 partners,
Could you explain why administer penicillin in poststrepto rheumatic fever, even after the actual steptococcal infection subsided (blood and throat culture are negative, and CBC is unremarkable, the acute rheumatic fever occurs 3-4 wks afterwards)?
Thanks.
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| fried water
Forum Junior
Topics: 4
Posts: 57
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its me again!!
i know why. coz even though the RF is over and no more strepts are present in yr body (negative throat culture).. you still need to administer 'penicillins' to prevent any further streptococcal infection. you know what i mean? like RF is an autoimmune disease and our body makes autoantibodies which destroy heart valves and other tissues.. and this autoimmunity occurs coz in actual our body made antibodies to fight against the bacteria (strept.) but coz some parts of strept are so much similar to our own body tissues that these autoantibodies also start destroying our own tissues!! So, to prevent any further production of this autoimmunity what you can do?>> prevent any further infection from strept, right?! So thats why you give 'penicillins' even if there is no current infection.
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| Larry
Forum Newbie
Topics: 8
Posts: 21
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Hi, Fried Water,
Nice to hear from you!
It's for prophylaxis. I agree with you. However, why don't administer penicillins to post-strepto nephritis? Basically, both pathology involve autoimmunity.
Thanks,
Larry
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| usmleasr
Forum Guru
Topics: 105
Posts: 970
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good q..both are ag-ab reactions..type 2 hypersensitivity damage in rheumatic fever....type 2/3 in AGN..
basically strains of streptococci causing them are different..i remember type12 strepto as most nephritogenic..
different strains for rheumatic fever..
what is seen clinically is recurrence with rheumatic fever never with AGN(may be due to difference in strains)..
and we know valve damage is more with recurrent damage in rheumatic fever..(M.R in carditis...progressing to M.S with recurrent attacks)..
so we go for prophylaxis only for rheumatic fever as benzathine pencillin given once in 3 weeks (very pain ful and clogs in syringe fast...so we use i.v needle and give the prick immediately after it is loaded..)
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| Dot
Forum Senior
Topics: 1
Posts: 168
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I think and i have studied that though Strain causing AGN does not produce RHD but the strains responsible for RHD cause AGN.Strains for AGN causes skin infection not throat and so not responsible for RHD.Plz clearfy this
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| Idiopathic
Forum Guru
Topics: 19
Posts: 641
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AGN comes from Group A Strep cellulitis
RF comes from Group A Strep pharyngitis
This is what we are taught here. Oral Pen V is given after pharyngitis to prevent RF, and that is the drugs only current use.
I dont have much more on it.
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