Introduction:

Rheumatic fever is an inflammatory disease that usually affects children and develops in them when scarlet fever or strep throat is left untreated or not adequately treated. A streptococcus bacteria infection usually causes these two diseases, scarlet fever, and strep throat. Rheumatic fever causes enough damage to the heart, including heart valve damage and heart failure. Rheumatic fever commonly affects children aged between 5 to 15, but it can also affect adults and younger children. Proper medication and treatment help to reduce pain and damage and prevent the recurrence of this disease.

Causes of Rheumatic Fever:

Rheumatic fever is usually caused due to the following reasons:

  • Rheumatic fever is generally caused due to the bacteria called group A streptococcus after a throat infection or skin infection.
  • It is caused when bacteria enter your body. During this fight, your immune system mistakenly attacks the healthy tissues, particularly in joints, the heart, the central nervous system, and the skin. It results in inflammation or swelling of the tissues.
  • Rheumatic fever is also caused when the strep throat infection or scarlet is not treated adequately with medications and antibiotics. 

Symptoms of Rheumatic Fever:

The symptoms of rheumatic fever change during the disease. The symptoms of rheumatic fever are usually based on the inflammation of the skin, heart, central nervous system, and joints. Rheumatic fever usually affects after 2 to 4 weeks of the strep throat infection. Some of the common signs and symptoms of rheumatic fever are the following:

  • High temperature
  • Pain in a joint that transfer to the other
  • Bleeding of nose
  • Vomiting
  • Shortness of breath
  • Pain in chest
  • Murmuring of heart
  • Unexplained ongoing headache
  • Small, painless bumps below the patient’s skin
  • Painful joints, usually of elbows, knees, wrists, and ankles
  • Fatigue
  • Painless rashes on the skin
  • Uncontrollable, jerky body movements, usually in feet, hands, and face
  • Unusual behavior such as sudden crying or laughing without any reason

When to see a doctor:

Immediately contact your doctor if you observe the above mention symptoms in your child. If your child is already suffering from a strep throat infection, treat it properly to avoid rheumatic fever.

Diagnosis:

During diagnosis, the doctor may ask about the patient’s medical history, family history, and symptoms. He may also ask about the recent bout of strep throat of your patient. After that, he takes a physical exam of the patient. During a physical exam, he diagnoses the following things:

  • He listens to the heartbeat of the patient to check the abnormalities of the heart
  • He examines joints inflammation
  • He will perform a movement test to determine the dysfunction of the nervous system.
  • Look at rashes on the skin.
  • Check the patient’s throat and sometimes take blood to test for strep bacteria.

He may order the following test:

  • Blood tests: Your doctor recommends a blood test to confirm strep infection, detect the level of antibodies, to check the substances like proteins that cause inflammation in the body.
  • Heart test: To check the functioning of the heart, your doctor may order for electrocardiogram or echocardiogram.  

Treatment of Rheumatic Fever:

Rheumatic fever treatment includes controlling symptoms and getting rid of strep bacteria. The following methods are included for the treatment of rheumatic fever:

  • Antibiotics: Antibiotics are beneficial in treating rheumatic fever and preventing it from reoccurring. Your child may receive lifelong antibiotic treatment.
  • Anti-inflammatory medication: Your doctor may also prescribe anti-inflammatory drugs such as aspirin(Bayer) or naproxen(Naprosyn, Aleve) to reduce inflammation and relieve joint pain. In severe cases, doctors may also prescribe corticosteroids to eliminate inflammation.
  • Anticonvulsant medication: Your doctor may also prescribe anticonvulsant medication for severe involuntary movements
  • Best test: Your doctor recommends bed rest, limiting your child’s activities during severe symptoms such as inflammation and pain. Strict bed rest is suggested for a few weeks to a few months in case the patient suffers from a heart problem. 
  • Other therapies: Other therapies, such as heart surgery and joint treatment, can be prescribed in severe cases. Your doctor recommends these therapies based on the severity of your disease. 

Risk factors:

Some of the following factors increase the risk of rheumatic fever:

  • Location: Some people live in developing countries with limited resources; in these cases, strep throat infection is not treated adequately and turns into rheumatic fever. A person living in a crowded area has more chances of being affected by rheumatic fever.
  • A specific type of strep bacteria: Certain strains of strep bacteria increase the risk of rheumatic fever more than other strains. 
  • Family history: If any family member has rheumatic fever, there is a greater chance that other family members will also be affected by this disease.
  • Overall Health: If a person has a weak immune system and is easily affected by strep throat infection more likely to get rheumatic fever.
  • Age: Age is another risk factor because this disease usually affects children or teenagers aged between 5 to 15

Complication:

Once the symptoms of rheumatic fever develop, it takes months to years to last. When rheumatic fever gets complicated, it may lead to the following diseases:

  • Aortic Regurgitation: In this, the aortic valve of the heart does not close properly and causes leakage in chambers of the heart
  • Atrial fibrillation: Irregular or rapid heartbeat which leads to blood clots in the heart
  • Damage to heart muscles: Rheumatic fever cause damage to heart muscles and decrease the ability to pump blood.
  • Aortic valve stenosis: Narrowing the heart’s aortic valve results in decreasing or blocking blood flow from the heart to the aorta.
  • Heart failure: When the heart does not pump blood to all body parts, it leads to heart failure. 

If the rheumatic fever is still left untreated, it may lead to:

  • Death
  • Stroke
  • Permanent heart damage

Preventions:

The prevention of Rheumatic fever is to treat scarlet fever or strep throat infection at the proper time with proper medications. Some hygiene methods that help prevent strep throat and scarlet fever are the following:

  • Wash your hands properly
  • Avoid sharing beds, towels, blankets, clothes, or any personal item with sick people
  • Always cover your mouth during sneezing or coughing
  • Avoid close contact with sick people

References:

  • https://www.healthline.com/health/rheumatic-fever#treatments
  • https://www.mayoclinic.org/diseases-conditions/rheumatic-fever/symptoms-causes/syc-20354588
  • https://my.clevelandclinic.org/health/diseases/16616-rheumatic-fever
  • https://www.webmd.com/a-to-z-guides/understanding-rheumatic-fever-basics
  • https://medlineplus.gov/ency/article/003940.htm
  • https://www.medicalnewstoday.com/articles/176648