Rheumatic fever is an inflammatory condition that can occur if strep throat or scarlet fever is not treated adequately. Streptococcus bacterium infection causes strep throat and scarlet fever.
Rheumatic fever is most common in children aged 5 to 15. It can, however, develop in younger children and adults. Unlike strep throat, rheumatic fever is uncommon in the United States and other affluent nations.
Rheumatic fever can cause lifelong heart damage, such as damaged heart valves and heart failure. Treatment can alleviate discomfort, lessen inflammation-related damage, and prevent rheumatic fever from recurring.
WHAT ARE THE SYMPTOMS OF RHEUMATIC FEVER?
The symptoms of rheumatic fever are caused by inflammation in the heart, joints, skin, or central nervous system. There might be one or several symptoms. Symptoms of the condition might alter over time. Rheumatic fever commonly appears 2 to 4 weeks following a strep throat infection.
Rheumatic fever symptoms and indicators may include:
- Fever
- Heart murmur
- Chest ache
- Fatigue
- Joint pain and tenderness, most commonly in the knees, ankles, elbows, and wrists
- Pain in one joint that spreads to another
- Joints that are red, heated, or swollen
- Painless rash with a ragged edge that is flat or slightly elevated.
- Uncontrollable, jerky bodily movements (Sydenham chorea) — most commonly in the hands, feet, and face
- Outbursts of odd behavior, such as sobbing or inappropriate laughter, that accompany Sydenham chorea
- Small, painless lumps beneath the skin
WHAT ARE THE CAUSES OF RHEUMATIC FEVER?
Rheumatic fever can develop following a throat infection caused by the bacterium group A streptococcus. Strep throat and, less often, scarlet fever are caused by Group A streptococcus infections of the throat.
Infections with Group A streptococcus in the skin or other regions of the body seldom cause rheumatic fever.
There is no obvious relationship between strep infection and rheumatic fever. The germs appear to deceive the immune system into attacking otherwise healthy tissue.
Infection-causing microorganisms are normally targeted by the body's immune system. The immune system incorrectly assaults healthy tissue in rheumatic fever, including the heart, joints, skin, and central nervous system. This defective immune system reaction causes tissue edema (inflammation).
When a strep throat infection is treated immediately with antibiotics and all medicine is taken as directed, there is little likelihood of developing rheumatic fever.
Rheumatic fever can develop if a kid has one or more bouts of strep throat or scarlet fever that are not appropriately treated.
WHAT ARE THE RISK FACTORS FOR RHEUMATIC FEVER?
The following factors may raise the risk of rheumatic fever:
- Genes: Some people have one or more genes that make them more susceptible to rheumatic fever.
- Specific type of strep bacteria: Certain types of strep bacteria are more prone than others to cause rheumatic fever.
- Environmental factors: Overcrowding, poor sanitation, and other factors that allow strep germs to spread readily among numerous individuals increase the risk of rheumatic fever.
WHAT ARE THE COMPLICATIONS OF RHEUMATIC FEVER?
Rheumatic fever inflammation can extend from a few weeks to many months. Long-term consequences are caused by inflammation in certain persons.
One consequence of rheumatic fever is lifelong cardiac damage (rheumatic heart disease). Rheumatic heart disease typically develops years or decades after the first sickness.
However, while your kid is still experiencing symptoms of the infection, acute rheumatic fever can begin to damage the heart valves. The valve between the two left chambers of the heart (mitral valve) is the most often damaged, however other valves can be impacted.
The following forms of heart damage can be caused by rheumatic fever:
- A heart valve narrowing (valve stenosis): This reduces blood flow.
- Heart valve leak (valve regurgitation): Blood travels backwards over the valve.
- Heart muscle damage: The inflammation caused by rheumatic fever can damage the heart muscle, impairing its capacity to pump blood.
Damage to the heart valves or other cardiac tissues can eventually lead to irregular, chaotic heartbeats (atrial fibrillation) or heart failure.
HOW IS RHEUMATIC FEVER DIAGNOSED?
Rheumatic fever cannot be diagnosed with a single test. Rheumatic fever is diagnosed based on a medical history, a physical exam, and specific laboratory results. Rheumatic fever tests may include:
- Blood tests: Blood tests can be performed to look for evidence of inflammation (markers) in the blood. C-reactive protein and erythrocyte sedimentation rate are two of these assays.
A blood test to identify antibodies to the strep bacterium in the blood is sometimes performed. The germs themselves may no longer be identifiable in throat tissues or blood.
- Electrocardiogram (ECG or EKG): The electrical activity of the heart is recorded during this examination. It can assist a doctor detect irregular heartbeats and establish if any portions of the heart are enlarged.
- Echocardiogram: Sound waves are employed to produce images of the beating heart. An echocardiography depicts the flow of blood through the heart and its valves.
WHAT ARE THE TREATMENTS FOR RHEUMATIC FEVER?
The aims of rheumatic fever treatment are to cure the infection, alleviate symptoms, reduce inflammation, and keep the illness from recurring.
Rheumatic fever treatment may include:
- Antibiotics: To treat strep bacteria, penicillin or another antibiotic is usually recommended.
After the initial antibiotic course is completed, a physician will usually prescribe another course of antibiotics to prevent the return of rheumatic fever. Preventive therapy will most likely continue until a kid reaches the age of 21, or until he or she has completed a minimum five-year course of treatment, whichever comes first.
People who have cardiac inflammation during rheumatic fever may need to take preventative antibiotics for 10 years or longer.
- Anti-inflammatory medications: Aspirin with naproxen (Naprosyn, Naprelan, Anaprox DS) can aid with inflammation, fever, and pain relief. If a child's symptoms are severe or he or she does not improve with anti-inflammatory medications, a corticosteroid may be administered. Do not provide aspirin to a youngster unless instructed to do so by a healthcare practitioner.
- Anti-seizure medications: To treat severe involuntary movements caused by Sydenham chorea, medications such as valproic acid or carbamazepine (Carbatrol, Tegretol, and others) may be utilized.
Long-term care
Discuss with your doctor what kind of follow-up and long-term treatment your kid will require for rheumatic fever.
Heart damage caused by rheumatic fever, known as rheumatic heart disease, can take years, if not decades, to manifest. Always inform your doctor if you have a history of rheumatic fever.
HOW CAN RHEUMATIC FEVER BE PREVENTED?
It is critical to treat strep throat and scarlet fever as soon as possible. It can help to avoid rheumatic fever. Symptoms of strep throat and scarlet fever aren't usually evident or easy to recognize. If your kid has a sore throat for more than three days or other symptoms that worry you, contact your healthcare professional.
If your kid has strep throat or scarlet fever, be sure to carefully follow your provider's advice. Even if your kid feels better, they must complete the entire course of antibiotics. Otherwise, the infection may persist and render you more susceptible to rheumatic fever.
CONCLUSION
Rheumatic fever is an uncommon complication. It can occur when treatments for strep throat or scarlet fever fail. It primarily affects young children and teenagers. In severe situations, it can cause major health issues affecting the heart, joints, or other organs. If you suspect one of these common bacterial illnesses, consult your physician soon away to avoid rheumatic fever. Rheumatic fever patients may require lifetime medical treatment to safeguard their health.