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2. A 16-year-old female patient with a history of tonsillitis 4 weeks before coming to the clinic presents to a physician with arthritis that has been moving from joint to joint (migratory polyarthritis). An echocardiogram reveals that the mitral valve is damaged and a sedimentation rate indicates the patient has acute inflammation which is later traced to the heart muscle. Follow the sequence of the heart. of events which explains how tonsillitis led to polyarthritis and damage

Explanation / Answer

2. Tonsilitis refers to inflammation of tonsils. This is caused due to infection of tonsils by viruses and bacteria. The major bacteria which is responsible for this infection is called as group A streptococcus. When bacteria is involved, the condition is called as strep throat.

Group A streptoccocus estaibilshes its pathogenicity by the help of 3 factors, M protiens, streptokinase and hyalarunidase. The important among these factors for inducing pathogenicity is M protiens. These protiens are found on the surface of bacteria and they protect them from host immune responses These M protiens induces formation of antibodies in the host body.

If this streptococcal infection is left untreated for longer period of time, more and more antibody formation is induced by M protiens of these bacteria. These antibodies start cross reacting with body's own tissues most commonly, the cardiac tissue, joints, nervous tissue and the skin. This leads to the condition called as rheumatic fever.

Rheumatic fever is a serious complication. It is an inflammatory illness that affects the heart, joints and other tissues. There occurs inflammation in joints and joint pain.Rheumatic fever affects heart tissues including muscles and valves leading damage to heart valves.

Rheumatic fever is a common cause of migratory arthritis. In migratory arthiritis ,pain spreads from one joint to other joint.

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