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Rheumatic Fever

The term "rheumatic" refers to viscous fluid or synovial joints of the body, implies an illness related with abnormalities of synovial joints. Synovial is a Viscid lubricating fluid secreted by the membrane lining joints and tendon sheaths etc. Any joint in the body which produces this fluid is known as a synovial joint. It commonly appears in children ages 6 through 15.

Rheumatic fever is associated with the development of heart valve disease  and other heart disorders. It can also affect joints, skin, and brain. Regarding joint pain, mostly larger joints, especially the knee, is most commonly involved. Later, the pain flits from one joint to another like knee, elbow, shoulder and ankle etc. About 3% of people with untreated strep infections get rheumatic fever.

Alternative Names: Acute Rheumatic Fever

Causes of Rheumatic Fever
Rheumatic fever is common worldwide and is responsible for many cases of damaged heart valves. When a common strain of bacteria known as "Strep," or "Streptococcus pyogenes", presented in the throat and nose for months without causing any harm becomes active, they produce an infection. The initial infection is sore throat and then inflammation and swelling of joints.

Usually within 1 to 5 weeks of throat infection, the disease develops. This illness can affect the normal lifestyle of the patient. The complication of the disease can be very grave.

Signs & Symptoms of Rheumatic Fever
Rheumatic fever symptoms start with redness and pain in the throat. Manifestation of the complaints varies from patient to patient. Usually, acute symptoms go off within 4-6 weeks. The common accompanying complaints are muscle pain, malaise, abdomen pain, vomiting, chest pain, nose bleed, restlessness, difficulty in breathing, pneumonia, difficulty in speaking or writing, tremors, etc.

  • Abdominal distress / pain
  • Chest pain
  • Confusion
  • Cough
  • Fatigue
  • Fever
  • Joint pain and swelling, redness or warmth
  • Lumps under the skin
  • Muscle pain
  • Nosebleed
  • Rashes
  • Shortness of breath
  • Skin eruption & nodules
  • Speech disabilities
  • Vomiting
  • Weakness

Diagnosis of Rheumatic Fever
Because this disease has different forms, there is no specific test that can firmly diagnose it. Following are a few major diagnostic measures which could helpful in diagnosis Rheumatic Fever:

  • Arthritis in joints
  • Heart inflammation
  • Nodules under the skin
  • Rapid, jerky movements
  • Skin rash
  • The minor criteria include fever, joint pain, high ESR, and other laboratory findings.

The doctor will perform a careful examination, which includes physical check up of body by checking heart sounds, skin, and joints. The diagnostic tests includes:

  • Blood Test: Blood samples may taken by the doctor to test for recurrent strep infection
  • E.C.G.: Doctor may perform an Electrocardiogram while testing your heart.
  • Throat swab & culture: Needed to rule out the type of bacteria in the initial days of throat pain
  • X-ray of chest and joints:  Required to rule out development of complications

Preventions of Rheumatic Fever

  • The most important and best way to prevent rheumatic fever is by getting quick treatment for strep throat and scarlet fever.
  • Penicillin reduces the risk of streptococcal throat infections and attacks of rheumatic fever in people who have already had a bout of rheumatic fever.
  • Penicillin for prevention can be given by injection or as tablets. Penicillin seemed to work better as injections than as tablets.
  • Injections given every two or three weeks worked better than when given every four weeks.

Treatments of Rheumatic Fever

  • Antibiotics: People who test positive for strep throat should also be treated with antibiotics such as penicillin, sulfadiazine, or erythromycin
  • Anti-inflammatory medications: such as aspirin or corticosteroids reduce inflammation to help manage acute rheumatic fever.
  • Medication: Medication will aim to avoid overexertion.
  • Surgery: Surgery may be needed to replace the damaged valve(s).

When to Call a Doctor
Call your doctor if you develop symptoms of rheumatic fever. Because several other conditions have similar symptoms, you will need careful medical evaluation. You will need to be evaluated and treated if you do have strep throat, to decrease your risk of developing rheumatic fever.

Concerned Doctor
Pediatrician Santosh Kondekar (MD DNB DCH FCPS child health specialist)
Soumitra Dutta (MRCP [Paeds. - UK], DCH [UK], D.N.B)
SUNIL PATEL (DCH)
Shishir Bhatnagar (MD)
K Nagaraju (---)
» More Doctors

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