The pericardial friction sound often masks a soft endocardial murmur. The advent adhesive pericarditis in children the most serious common feature rheumatism, since found in the severe types infection, accompanied myocardial changes, and prevents eflicient compensation valvular defects in after years.
Audible and palpable friction, precordial distress, increased frequency the pulse and respiration, anxious countenance and delirium may noted.
The increase cardiac area may as much from dilatation a heart weakened accompanying cheap essay service myocardial changes as from effusion. Delirium, lividity and signs heart failure are the gravest significance. Chronic adhesive pericarditis, perhaps with mediastinitis and even multiple serositis, may develop years afterwards.
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In the rare purulent pericarditis the friction may not perceptible because the lubricating effect the pus, but the general signs extreme danger are present nevertheless.
Lungs and Pleurae.
Pleurisy with serous effusion not uncommon and some extent amenable rheumatic treatment. Pneumonia may occur.
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In case heart failure in pericarditis and myocarditis, acute pulmonary congestion may add the danger. A rheumatic involvement the peritoneum recognized some Nervous System.
The severer attacks hyperpyrexia alluded are called cerebral rheumatism some authors.
The delirium produced salicylates should differentiated. The frequent association chorea with rheumatism has long been noted. Tt follows the disease in about, the cases and a micro-organism has been isolated from the brain lesions a fatal case which produced rheumatic symptoms in rabbits.
The severity the heart lesions in children, in whom the two diseases have occurred together, very striking. Local neuritis, ordinary help with writing assignments multiple neuritis and meningitis may occur. A rheumatic paraplegia has been described. Phlebitis a rare complication. need help with writing a thesis statement Post-febrile anemia common, and was even more when the alkaline treatment was in vogue. Subacute rheumatism resembles the acute cover letter writing services toronto form excepting in the milder course and oftentimes longer duration. Chronic rheumatism may result. Diagnosis The direct diagnosis easy in typical cases, and commonly made need to buy an essay the laity before the physician called. The frequent history previous attacks and tonsillitis, irregular fever sudden onset, with joint involvement, as outlined above, with pain, sweats, and cardiac involvement, suffice for the diagnosis.