Rheumatic fever

What is rheumatic fever mean?

Rheumatic fever is an inflammatory disease that can happen after a person becomes infected with the Streptococcus bacteria.

It is common condition found in young children’s.

Causes of rheumatic fever

Generally post streptococcal infection of throat is common cause for rheumatic fever. In few cases scarlet fever may be associated with it.

How does it happen?

 Stptoccocal throat infection is responsible for the development of rheumatic fever.

Streptococcus pyogen secrets toxin which act as antigens for body cells .B cell activate and proliferates antibodies to neutralize antigenic toxin  which further deposits on wall of heart valves leading to either stenosis or prolapsed valve. The Rheumatic Fever begins with chills stage then heat, trachycardia, intense thirst, loss of appetite and weakness. Antigen aggregation may lead to nodule formation underneath the skin .

Who are at Risk?

·        Children ages 5 to 15 year, particularly if they have repeated strep throat infections.

·        Children having family history of rheumatic fever.

What are Symptoms and signs?

Rheumatic fever has following sign and symptoms:

·        Fever with chills

·        Painful joints swelling on the ankles, knees, elbows, and wrists.

·        Radiating pain in joint

·        Swelling of joint

·        small nodules  under the skin  specially on bony prominence of leg

·        chest pain

·        chest palpitations

·        Weakness

·        narrow breathing

·        confusion of thoughts

·        sweating specially on palm

·        jumpy uncontrollable hand, feet movements with face twitching

Talk to doctor and get advice on sign and symptoms of Rheumatic fever.

What is Complication of rheumatic fever?

·        mitral valve stenosis

·        mitral valve prolapse

·        tricuspid valve regurgitation

·        cardiac arrhythmia

·        atrial  fibrillation

·        heart failure

·        rheumatic arthritis

Diagnosis, Test & Interpretations

Rheumatic fever is diagnosed with proper history of streptococcal throat infection along with other test includes:

·        Mainly diagnosis is done on past history with physical observation of skin nodules.

·        movement tests to determine nervous system dysfunction

·        blood tests for streptococcal antigen ratio I.e. ASR titer

·        ECG

·        echocardiography

What are treatment Recommendations    

A.   Lifestyle changes

·        Restrict physical activities until inflammation, pain and other symptoms have improved.

·        Strict bed rest if inflammation in cardiac muscles is present.

B.   Medications

Rheumatic fever if not treated properly it may cause several cardiac problems so, it should be treated with proper course of medication.

Antibiotic

·        Penicillin

·        Erthryromycin

Anti inflammatory medicine

·        Aspirin

·        Prednisone

ACE inhibitors

·        Enalapril

·        Captopril

C.   Special Care

The only known way to prevent rheumatic fever is to treat strep throat infections or scarlet fever promptly with a full course of appropriate antibiotics.

Prevention

·        The only known way to prevent rheumatic fever is to treat strep throat infections or scarlet fever promptly with a full course of appropriate antibiotics.

·        Treat acute streptococcal pharyngitis immediately.

Type of doctor to be visited?

·        Cardiologist

·        Any qualified medical physician

·        Rheumatologist