Rheumatic Fever

Rheumatic Fever – Its Symptoms and Treatment

Rheumatic Fever is an inflammatory disease that is caused due to the Group A streptococcal bacteria. It often develops after an attack of scarlet fever or strep throat. It is so called because of its similarity to rheumatism that involves medical problems affecting various connective tissues and joints. It can severely affect the brain, heart and joints if not treated at the early stage. Mostly, the recurring episodes of rheumatic fever mostly affect people when they are between 24 to 30 years of age.

According to some researchers, rheumatic fever is actually a delayed autoimmune reaction to the bacterial infection and can also be prevented with the timely diagnosis and treatment of scarlet fever and strep throat. It mainly affects the children between 5 and 14 years of age, and usually occurs twenty days after scarlet fever and strep throat.

Rheumatic fever is uncommon in the US, but sometimes occurs in the children who do not complete ten day course of treatment for the strep throat or do not get the treatment at all.

Other body parts that are affected by Rheumatic Fever

Aside from heart and the joints, the central nervous system can also get involved. The patient may experience sudden, irregular and jerky movements at variable time period. This manifestation of Rheumatic Fever is known as rheumatic chorea. This can even occur independently, even without this fever.

Sometimes, skin may also get involved due to the allergic response, and the condition is referred to as rheumatic subcutaneous nodules. They are quite hard and lie just beneath the skin and cause no pain to the patients. They are about 2.0 cm in size. These nodules are found mostly in the bony areas such as feet, back of the hands and patella.

They may disappear in no time and may also recur in the newer areas. Mostly, they occur with some other features of
rheumatic fever.

In few cases, allergic skin rashes may appear in the form of circles. They may join giving various shapes to the lesion. Just like subcutaneous modules, they are mostly accompanies by the cardiac lesion. These rashes disappear when the acute stage of Rheumatic Fever is over. These rashes occur mostly on the lower and upper limbs, and on the back of patient.

The sore throat may not help in the diagnosis, as actual manifestations of Rheumatic Fever may occur after 8-20 days of the sore throat. Hence, from the above discussion, it is amply clear that the various symptoms of Rheumatic Fever, such as heart, central nervous system, joints, skin etc. may occur independently of each other, or even in different combinations, so both the physician and the patient should remain quite vigilant in the early the early stages before any firm diagnosis is done.

Symptoms Of Rheumatic Fever

•Skin eruptions on the trunk and upper part of the legs or arms

•Fever

•Abdominal pain

•Joint pain, arthritis (in the elbows, knees, wrists, and ankles)

•Heart problem without any symptoms. Feeling of chest pain and shortness of breath

•Nosebleeds (epistaxis)

•Swelling in joints; warmth or redness

•Skin nodules

•Eruptions that appear snake-like or ring-shaped

•Skin rash (erythema marginatum)

•Sydenham chorea (muscle weakness, quick and uncoordinated jerky movements that affect the hands, feet, and face,

emotional instability)

Treatment of Rheumatic Fever

There is no proven cure for rheumatic fever but it is definitely possible to alleviate pain that is caused by some of its symptoms. It is possible to prevent re-occurrence of streptococcal infection by administering antibiotics such as penicillin to the patient. Sometimes, aspirin is administered for reducing the fever.

Corticosteroids are also given to some patients who experience swelling and joint pain. Administration of low doses of sulfadiazine, erythromycin and penicillin over a long time period can help in preventing the occurrence of strep throat infection from occurring again.

Often, bed rest is also recommended for few patients for providing some time to the body to heal. Doctors often recommend the increased intake of fluids (7-10 glasses of water per day) to the patients.

Complications that occur due to the Rheumatic Fever

•Heart inflammation- This involves inflammation of lining and muscle.

•Arrhythmias- heart rhythm disorder

•Pericarditis- inflammation of sac-like covering and pericardium of the heart

•About eight percent of the patients develop small painless nodules and lumps, on spine, prominent bones at elbows,

ankles and knees. Sometimes, a rash may resembling rings may also appear on the skin. In most of these cases, such

problems eventually resolve themselves.

•Rheumatic Heart Disease-This may occur due to previous episode of rheumatic fever.

•Sydenham Chorea- spasmodic/ involuntary movements of the body.

•Endocarditis- deals with certain abnormalities that occur in endocardium ( these are innermost tissues that lines the

chambers of the heart)

•Congestive heart failure-This is a serious heart condition where it is not able to pump sufficient blood to the

entire body.

Diagnosis of Rheumatic Fever

Diagnosis is of Rheumatic Fever is based on the medical history of the patient and the physical examination. Blood tests may be done.

Expectations (prognosis)

There are chances that Rheumatic fever may come back in the people who don’t take low-dose antibiotics on regular basis, especially during the first two to five years after the first episode of this disease. Heart complications can
be severe, particularly if the heart valves are also involved.

Prevention of Rheumatic Fever

Physicians are still searching for ways to reduce the damage to the heart value caused by rheumatic fever. Therefore, it is best to treat this disease promptly by timely consumption of antibiotics. It is possible to prevent the initial episode of rheumatic fever with early treatment of strep throat with the antibiotics.

Treatment of Rheumatic Fever

Currently, there is no cure for rheumatic fever, but it is possible to use medications for controlling the symptoms and eradicating the streptococcal infection from the body. The treatment mainly consists of antibiotics such as penicillin. Steroids and aspirin is also administered in some cases. Aspirin is known to reduce fever and also relieves swelling and fever. Corticosteroids can also be used if aspirin is found to be inadequate.

To prevent the recurrent rheumatic fever in the people who have already had one episode, doctors usually recommend monthly injections of penicillin for some time as they are  quite effective in controlling the infection.