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Rheumatic Fever

Rheumatic fever is an inflammatory condition, which occurs as a complication when strep throat or scarlet fever is not treated completely ,

What do we need to know about rheumatic fever?

Rheumatic fever happens after a throat infection from a bacteria called group A streptococcus. Group A streptococcus can also less commonly cause scarlet fever.

As to what is the link between strep infection and rheumatic fever we do not know for sure , but one fact is that strep bacteria has a protein similar to the one found in some tissues of the body. The immune system of the body, which generally targets infection-causing bacteria, attacks its own tissue, particularly the tissues of the heart, central nervous system, joints and skin. 

This disease is a serious illness, common in children between 5 and 15 years of age. Rheumatic fever usually occurs after two to four weeks of getting strep throat or scarlet fever that has not been treated appropriately . 

What are the symptoms of rheumatic fever?

Symptoms include:

The signs and symptoms of Rheumatic fever, which result from inflammation in the central nervous system, heart, joints or skin may include:

  • Chills and fever
  • Pain and tenderness in joints, mostly on ankles, elbows, knees and wrists
  • Pain in a joint that travels to another joint
  • Red, hot or swollen joints
  • Small, painless bumps beneath the skin
  • Chest pain
  • Fatigue
  • Heart murmur Heart palpitations
  • Slightly raised or flat, painless rash with a ragged edge
  • Migrating pain from one joint to another 
  • Red rashes on body
  • Nose bleeding
  • Stomach pain
  • Small and painless bumps under the skin
  • Jerky, uncontrollable face and limb movements (Sydenham chorea) 
  • Outbursts of unusual behavior like crying or inappropriate laughing, which accompanies Sydenham chorea

What are the causes of rheumatic fever?

Rheumatic fever occurs when bacterial  infections like strep throat and conditions like scarlet fever are not properly treated. Both these conditions are caused by the Group A streptococcus  bacteria. The streptococcus bacteria causes autoimmune response in the tissues of the skin and other parts leading to severe inflammation in the body.

When do you need to see a doctor?

If your child is showing symptoms like fever, sudden throat pain , difficulty in swallowing, stomach ache and headache, immediately seek medical attention.

Request an appointment at Apollo Hospitals. 

Call 1860-500-1066 to book an appointment.

What are the risk factors linked to rheumatic fever?

Factors that increase the risk of rheumatic fever are:

  • Family history of rheumatic fever
  • Certain infectious strains of streptococcus
  • Unhygienic environment as it increases the chances of growth and transmission of infection-causing bacteria.

What are the complications?

Considering rheumatic fever can last up to few weeks to months, it can cause long-term complications like:

  • Chances of permanent heart damage usually 10 to 20 years after the disease
  • Chances of heart valves getting damaged in children during rheumatic fever
  • Narrowing of heart valves causes decrease in rate of blood flow
  • Damaged heart muscles
  • Leakage in the valves
  • Atrial fibrillation 

How can this disease be prevented?

The only possible way to avoid rheumatic fever is proper and right treatment of scarlet fever or strep throat infections.

What are the treatment options for rheumatic fever?

Treatment of rheumatic fever focuses on not only controlling the inflammation but also on completely destroying the streptococcus bacteria to prevent reinfection in future. Treatments include:

  • Antibiotics: antibiotics like penicillin are administered first to treat the current disease. After the treatment for 5 to 10 years depending upon the condition, other antibiotics are given as preventive medicines to avoid reinfection in future. 
  • Anti-inflammatory treatment: pain relievers like aspirin or naproxen are given to reduce fever, pain and inflammation.
  • Anticonvulsant medications: these are given to control the abnormal movements caused by Sydenham chorea.
  • Heart damage from rheumatic fever may not show up for many years. When your child grows up, he/she has to include the information in his/her medical history and get regular heart examinations

Conclusion 

Incomplete or lack of treatment of scarlet fever and strep throat increases the chances of developing rheumatic fever. Proper and accurate treatment of strep throat  or scarlet fever can prevent rheumatic fever.

Frequently Asked Questions (FAQs)

Can adults get infected with rheumatic fever?

Yes, but it’s very rare.

Is this disease contagious?

Rheumatic fever itself is not contagious but it occurs because of the undertreatment of two contagious conditions, scarlet fever and strep throat infection.

How is this condition diagnosed?

  • Diagnosis of the strep infection by using a throat swab test
  • Blood test which can detect antibodies to the strep bacteria in the blood 
  • Blood tests to detect the amount of  inflammatory markers, C-reactive proteins and erythrocyte sedimentation rate 
  • An electrocardiogram (ECG) can also be done, if required.
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