July 29, 2012

Concerning features of Rheumatic fever

A young girl is suspected of having an acute attack of Rheumatic fever. During the acute phase of Rheumatic fever the characteristic inflammatory lesions found in the heart are known as:

a) Ferruginous bodies
b) Foamy macrophages
c) Aschoff bodies
d) Granuloma
e) Streptococcal laden macrophages

The correct answer is C

Aschoff bodies is the name given to the characteristic inflammatory lesions found in the heart in acute Rheumatic fever. They constitute foci of fibrinoid necrosis surrounded by lymphocytes, macrophages, occasional plasma cells and plump activated histiocytes called the aschoff cells. These lesions are sterile and do not contain any bacteria. Aschoff body is pathognomonic of acute Rheumatic fever.

Ferruginous bodies are iron coated asbestos particles seen in pulmonary asbestosis. They are not seen in rheumatic fever. Foamy macrophages are lipid laden macrophages seen in an atherosclerotic plaque and are not seen in rheumatic fever. Granuloma is focus of inflammation characterized by activated macrophages called epitheloid cells. They are seen in a variety of infectious and non-infectious conditions but are not seen in rheumatic fever.

E is not the correct answer because even though Rheumatic fever takes place following a streptococcal infection it is more of an autoimmune reaction to the streptococcal antigen and the lesions are sterile not containing any bacteria.

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