Bacteriological and Serological Study among Patients Suffering from Rheumatic Fever

The aim of this study was to help in increasing the sensitivity and specificityof rheumatic fever (RF) diagnosing. One hundred and eight patients and volunteers were selected from Orthopedic Surgery Department at ElSahel Teaching Hospital (Cairo-Egypt), during the period from January 2008 to October 2009. Their ages ranged from 3 to 25 years old. Patients were divided into four groups. The first group (22 patients) who were hospitalized after clinical diagnosis as acute rheumatic fever patients. The second group (28 patients) and the third group (30 patients) had history of rheumatic fever. The second group did not take long acting penicillin (L. A. P.), whereas, the third group took L.A.P. once a month, as a prophylactic treatment. The different groups of rheumatic fever patients were compared with healthy control group (28 individuals) with respect to the incidence of AntistreptolysinO (ASO), Antistreptococcal Hyaluronidase (ASH), Antistreptokinase (ASK), antistreptodornase B (anti-DNaseB), Erythrocyte Sedimentation Rate (ESR), Hemoglobin content (Hb), Red blood cells (RBCs) count, total and differential leucocytes count as well as bacteriological detection of Bhemolytic streptococcal infection. The incidence of positive tests of ASO, ASH, ASK, and anti-DNaseB was decreasing between all groups in the following pattern I > II > III> IV. In addition, the mean values of all hematological parameters, except for Hb. and RBCs count, were following the above mentioned pattern. Both serological and hematological results of group III patients did not show any significant differences from those of healthy group IV. The sensitivity of the above serological tests in diagnosis of rheumatic fever was increasing in the following pattern anti-DNaseB > ASO > ASH > ASK.