Module-6 Assignment #1 (Case study)

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Apr 3, 2024

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1 Case Study # 2 Juhi Chetan Kavi Department of Dental Hygiene Goodwin University DHP 102: Periodontology Mrs. Christine Walsh February 13, 2024

2 Streptococcus bacteria are commonly found in the respiratory tract, skin, and mucous membranes. The species of the group A streptococcus or streptococcus pyrogens which cause infections of strep throat and superficial infections like skin, fever, pharyngitis, invasive infections like cellulitis, and immune-mediated infections like acute rheumatic fever and rheumatic heart disease (Auala et al., 2022). The connection between a streptococcal skin infection and the development of rheumatic heart disease (RHD) lies in the body's immune response to the initial infection. When the bacteria infect the skin, they can cause localized inflammation and tissue damage. The innate immune system detects the presence of streptococcal bacteria and begins its first defense against the infection (Gehrig & Shin, 2024). This defense involves the activation of various immune cells and the release of inflammatory mediators to destroy the bacteria. The adaptive immune system utilizes specialized cells such as B and T cells to fight the bacteria. In some individuals, particularly those genetically predisposed, the immune response to streptococcal infection can lead to an autoimmune reaction known as molecular mimicry. This occurs when the antibodies produced by the immune system to target the streptococcal bacteria mistakenly recognize and attack proteins in the body's tissues that resemble those of the bacteria. In the case of RHD, the proteins in the heart valves and other cardiac tissues may resemble those of the streptococcal bacteria (Auala et al., 2022). As a result of the autoimmune reaction, the antibodies and immune cells target the heart tissues, causing inflammation and damage. This primarily affects the heart valves, leading to a condition known as rheumatic valvulitis. Permanent damage to the heart valves occurs due to repeated inflammation and scarring. Ultimately this compromises the normal function of the heart valves leading to conditions such as valve stenosis and regurgitation (Auala et al., 2022). The damage to the heart valves can

3 progress if left untreated and this develops into rheumatic heart disease. This can manifest as symptoms such as shortness of breath, chest pain, fatigue, and palpitations, and can ultimately result in serious complications such as heart failure, arrhythmias, or infective endocarditis (Carapetis et al., 2016).

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4 References Auala, T., Zavale, B. G., Mbakwem, A. Ç., & Mocumbi, A. O. (2022, April 21). Acute rheumatic fever and rheumatic heart disease: Highlighting the role of Group A streptococcus in the global burden of cardiovascular disease . MDPI. https://www.mdpi.com/2076- 0817/11/5/496 Carapetis, J. R., Beaton, A., Cunningham, M. W., Guilherme, L., Karthikeyan, G., Mayosi, B. M., Sable, C., Steer, A., Wilson, N., Wyber, R., & Zühlke, L. (2016, January 14). Acute rheumatic fever and rheumatic heart disease . Nature News. https://www.nature.com/articles/nrdp201584 Gehrig, J. S., & Shin, D. E. (2024). Foundations of periodontics for the dental hygienist (16th ed.). Jones & Bartlett Learning.

Module-6 Assignment #1 (Case study)

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