Prevention of Rheumatic Fever by Continuous Photodynamic Therapeutic
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 18, Issue 4
Abstract
Introduction: Non and suppurative complications such as rheumatic fever and poststreptococcal acute glomerulonephritis may occur post-pharyngotonsillitis (PT). The conventional treatment of bacterial PT consists of orally administered antibiotics. Rheumatic fever (RF) incidence in developing countries with high prevalence PT are significant public health concerns. The diagnosis is imprecise due to difficulty of detecting the etiologic agent by laboratory methods in some countries. Associated with this, the dissemination of bacteria resistance to multiple antimicrobial agents to secondary prophylaxis by PDT was analyzed in cases of PT complications. Case Report: A 37-year-old woman was clinically diagnosed with recurrent streptococcal PT. The second episode of PT associated to asymmetric arthritis and the results of lab tests lead to the diagnosis of rheumatic fever. A PDT session was performed every 30 days as secondary prophylaxis. Conclusion: This case hypothesis that oropharyngeal PDT may be an effective prophylactic treatment of rheumatic fever. However, more research is needed to test this theory.The main cause of PT is Streptococcus pyogenes, Lancefield group a beta hemolytic streptococcus (EBHGA) Ba -Saddik et al. The relative frequency of microorganisms depends on the age, geographic region and season in which they occurred Principi et al. The clinical diagnosis of Streptococcal PT can promote correct treatment and prevention of complications. However, there is no clinical sign or symptom that accurately identifies this bacterial infection. The etiological diagnosis depends on the detecting the agent by lab methods. Clinical scoring systems can be used as a reference to minimize the risk of EBHGA infection in places poor living conditions. Acute PT represents a source of social disorders and repeated use of antibiotics way [1]. It presents complications such as peritonsillar and retropharyngeal abscess, otitis, sinusitis, pneumonia, rheumatic fever and poststreptococcal glomerulonephritis. According to the World Health Organization (WHO) new cases of PT (around 600 million) occur due to EBHGA which 500 thousand can progress to RF about 300 thousand rheumatic carditis (CR). International organization such as the World Heart Federation (WHF), the WHO and the African Union have promoted scientific measures to eradicate these diseases. A GAS infection does not need to be symptomatic disease to trigger a recurrence. However, prevention of disease recurrence requires continuous antimicrobial prophylaxis. Secondary prevention of rheumatic fever is performed with prophylaxis initiated as soon as the disease is diagnosed. A complete antibiotic cycle should be administered in order to treat acute rheumatic and eradicates residual GAS. RF is an inflammatory disease and results from an autoimmune response to infection caused by GAS (CARAPETIS; MCDONALD; WILSON, 2005). Monthly doses of penicillin for rheumatic fever treatment has been approved for carditis (10 years) and RF (5 years). Photodynamic antimicrobial therapy is a noninvasive therapeutic modality for treatment of infectious diseases caused by different bacterial species [2]. Oxygen‐Dependent Photochemistry reaction occurs in response to the activation of PS by a light source leading to the generation of cytotoxic reactive oxygen species. PDT has been effective and safe for use in the oral cavity for both dental and oral disinfection.
Authors and Affiliations
Kate C Blanco, Jennifer M Soares, Natalia M Inada, Vanderlei S Bagnato
Keywords
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- EP ID EP622710
- DOI 10.26717/BJSTR.2019.18.003190
- Views 176
- Downloads 0
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