Rheumatic Fever

Rheumatic fever is a disease caused due to complications from strep throat and scarlet fever. It acutely affects the heart, joints, brain, and skin. It usually appears in children from 5 to 15, but older children and adults are also known to have contracted the disease. Early detection and treatment can prevent the fever from aggravating.

Symptoms of Rheumatic Fever

Rheumatic fever is caused more frequently in children but also in some adults. Here are major symptoms of Rheumatic fever in adults.

• Fever
• Painful joints
• Fatigue
• Chest pain
• Inflammation in joints, ankles, knees, elbows, and wrists.
• Body movements go out of control (known as ‘chorea’)
• Lumps near joints (nodules)
• Rash (appear as pink circles with a clear center)
• Fluid around heart
• Enlarged heart 
• Heart murmur

One needs to visit a doctor if the following symptoms are seen in children:

• Sore throat
• Pain when swallowing
• Fever
• Headache
• Nausea, stomach pain, or vomiting

Causes of Rheumatic Fever

• Rheumatic is a rare but life-threatening disease caused by the complication of strep throat, which in turn is caused by the bacteria streptococcus. 
• It is an inflammatory disease that mainly impacts the joints, heart, nervous system, skin and can be fatal. 
• Almost 5% of those with strep throat are known to be impacted by Rheumatic fever. It takes about 1- 5 weeks after scarlet fever or strep throat for the rheumatic fever to develop. 
• The cause of strep infection and rheumatic fever is unknown, although the germs appear to deceive the immune system.
  • The strep bacteria carry a protein similar to one found in the body's tissues. The body's immune system, designed to fight infection-causing microorganisms, instead destroys healthy tissue such as the heart, joints, skin, and central nervous system. The tissues enlarge due to the immune system's reaction (inflammation).
• There's a low risk your child may develop a rheumatic fever if they receive quick antibiotic treatment to remove strep bacteria and take all medications as directed.
• Your child may get rheumatic fever if they have one or more bouts of strep throat or scarlet fever that aren't treated or aren't treated entirely.

Diagnosis and Tests

Based on primary symptoms like fever or sore throat, the doctor may check for group A streptococcus bacteria through a throat swab test. This is called a rapid strep test or throat culture test. 

There are other sets of tests that the doctor may recommend additional tests like:

Blood Tests

To confirm a strep infection, doctors may request a blood test. When bacteria no longer show up on testing, blood tests can identify antibodies (your body's defenses against the germs). Other blood tests look for molecules (like proteins) in the body that indicate inflammation.

Heart Tests

Providers use heart tests like an electrocardiogram (ECG) or echocardiography (heart ultrasound) to examine your heart function.

Rheumatic Fever Treatment

The goal of rheumatic fever treatment is to eliminate the bacterial infection initially. Treatments then address inflammation inside the body.

Treatments for rheumatic fever include:

Antibiotics: Antibiotics are prescribed by healthcare providers to treat the underlying bacterial infection. Some antibiotics are given as a single injection (shot). Others are taken orally for a week or longer.

Anti-inflammatory medications: Your doctor will most likely prescribe aspirin or another anti-inflammatory medicine to lessen inflammation (swelling) throughout the body. This drug may also help with symptoms like joint pain. If you have severe symptoms, your doctor may prescribe a more potent anti-inflammatory drug (corticosteroids).

Other treatments include: Rheumatic fever can have various effects on people. Depending on how your disease affects you, your doctor may suggest alternative therapies. If your condition is severe, you may need cardiac surgery or joint treatments to treat serious complications.

Risk Factors

Although rheumatic fever is caused by a complication of the streptococcus bacterial infection, several factors could aggravate the risk of contracting it.

1. Family History: Although this is not proven completely, rheumatic fever may be caused due to a gene or genes, increasing the risk.
2. Type of Bacteria: Certain strains of strep bacteria are more prone than others to cause rheumatic fever.
3. Environmental Factors: Overcrowding, poor sanitation, and other factors that might easily result in rapid transmission or multiple exposures to strep germs are linked to a higher risk of rheumatic fever.
4. Age: Rheumatic fever affects children between ages 5 -15.

Complications

Rheumatic fever might permanently damage the heart (rheumatic heart disease). Although it happens typically 10 to 20 years after the first infection, severe episodes of rheumatic fever might damage one’s heart valves. The valve that connects the two left chambers of the heart (mitral valve) is the most commonly impacted; however other valves can also be affected.

The following are some consequences of the damage:

• Narrowing of the valve: Blood flow is reduced due to this.
• Leak in the valve: Blood flows in the wrong direction due to a leaking valve.
• Heart muscle damage. Rheumatic fever's inflammation can damage the heart muscle, reducing its ability to pump blood.