Know All About
RHEUMATIC FEVER
Definition:
It is the after effect of throat infection, caused by virulent bacteria known as “B” group streptococci, that may affect the entire body and is caused by altered immune response. Rheumatic fever most commonly affects joints, skin and subcutaneous tissues. If not diagnosed and treated in time, it damages the heart. Strepto infections are contagious, but rheumatic fever is not.
Sex or Age most Affected
All age groups, especially Pre-school children.
Signs & Symptons
- Pain, redness, swelling and warmth in joints, which, characteristically spreads from one joint to another (fleeting joint pains). Wrists, elbows, knees or ankles are most often affected. Joint inflammation usually subsides in 10 to 14 days, but without treatment, other joints may become inflamed.
- Fever; fatigue; paleness.
- Appetite loss; general ill feeling.
- Abdominal pain; chest pain.
- Mild skin rash on the chest, back and abdomen.
- Small, painless lumps just under the skin in bony areas such as the elbows or knees.
If the heart is involved:
- Shortness of breath.
- Water retention that causes swelling of the legs and lower back.
- Rapid heartbeat, especially when lying down.
- Uncontrollable arm and leg movement (chorea).
Causes
Streptococcal throat infection occurs 1 to 6 weeks before onset of rheumatic fever. Rheumatic fever probably has to do with body immunity wherein antibodies produced to attack the streptococcal bacteria also attack tissues of the joints or heart.
Risk Increases With
- Poor nutrition.
- Family history of rheumatic fever.
- Crowded or unsanitary living conditions.
- Recurrent streptococcal throat infections.
Prevention
- Ask your doctor whether a throat culture for streptococci is needed for a throat infection, especially in a child.
- Obtain prompt antibiotic treatment of any streptococcal infection, including those of the skin. ABSOLUTELY NO SELF-MEDICATION. Streptococcal infections must be treated with appropriate dosage of antibiotics, for a minimum of 10 days and in proven rheumatic cases long acting antibiotic injections may be required for as long as 18 yrs.
Diagnostic Measures
- Observation of symptoms.
- Medical history and physical exam by a doctor.
- Laboratory studies such as blood studies, a throat culture and ECG.
- X-rays of the chest.
- 2-D Echo
Possible Complications
Permanently damaged heart valves (Rheumatic Heart Disease), leading to congestive heart failure.
Probable Outcomes
Usually curable with treatment. In some cases, rheumatic fever may damage the heart valves. A damaged valve can be replaced with surgery.
In rare cases, rheumatic fever is fatal-even with treatment.
TREATMENT
General Measures
- Take the patient’s temperature and count the pulse; keep a record for your doctor.]
- Give steam inhalation if the patient has a sore throat or cough.
Medication
Your doctor may prescribe:
- Steroids (anti-inflammatory drugs) or aspirin to reduce inflammation.
- Diuretics to reduce fluid retention.
- Antibiotics to fight any remaining streptococcal bacteria. Once rheumatic fever reaches the inactive stage, low-dose antibiotics may be continued indefinitely to prevent recurrence.
Activity
The patient should stay in bed until studies show the disease has subsided. Bed rest for 2 to 5 weeks is usually required, but some cases require months. Provide a bedpan or bedside commode so that the child won’t have to get up to use the bathroom.
Contact your Doctor
Your child has symptoms of rheumatic fever.
The following symptoms occur during treatment:
- Swelling of the legs or back
- Shortness of breath
- Vomiting or diarrhea
- Cough
- Severe abdominal pain
- Fever
- New, unexplained symptoms develop. Drugs in treatment may produce side effects.