Rheumatic Fever: Symptoms, Causes, Treatment

What are the symptoms of rheumatic fever?

Rheumatic fever is an inflammatory disease that can develop as a complication of untreated or inadequately treated strep throat caused by group A Streptococcus bacteria. The symptoms of rheumatic fever can vary widely and may affect the heart, joints, skin, and other parts of the body. Common symptoms of rheumatic fever may include:

  1. Fever: Rheumatic fever often begins with a high fever, which may come on suddenly and is usually higher than 100.4°F (38°C).
  2. Joint Pain: Joint pain and swelling, often affecting the knees, ankles, elbows, and wrists, are common symptoms of rheumatic fever. The pain may migrate from one joint to another.
  3. Joint Swelling: Affected joints may become swollen, red, and warm to the touch.
  4. Joint Stiffness: Stiffness, especially in the morning or after periods of inactivity, may occur in affected joints.
  5. Cardiac Symptoms: Rheumatic fever can affect the heart, leading to symptoms such as chest pain, shortness of breath, rapid or irregular heartbeat (palpitations), and fatigue. In severe cases, rheumatic fever can cause damage to the heart valves (rheumatic heart disease).
  6. Skin Rash: A rash may develop, characterized by flat or slightly raised, painless, red or pink spots that typically appear on the trunk and extremities. The rash may have a “lacy” or “net-like” appearance.
  7. Subcutaneous Nodules: Small, painless nodules or lumps may develop under the skin, typically over bony areas such as the elbows, knees, or knuckles.
  8. Sydenham’s Chorea: In some cases, rheumatic fever can cause a condition known as Sydenham’s chorea, characterized by involuntary muscle movements, especially in the face, hands, and feet. This condition is more common in children.
  9. Fatigue: Generalized weakness and fatigue are common symptoms of rheumatic fever.

It’s important to note that not all individuals with rheumatic fever will experience all of these symptoms, and the severity of symptoms can vary. If you or someone you know has symptoms of rheumatic fever, it’s important to seek medical attention promptly for diagnosis and treatment.

What are the causes of rheumatic fever?

Rheumatic fever is caused by an abnormal immune response to infection with group A Streptococcus bacteria. This bacterium is responsible for strep throat, and rheumatic fever typically develops as a complication of untreated or inadequately treated strep throat. The exact mechanism by which group A Streptococcus bacteria trigger rheumatic fever is not fully understood, but it is believed to involve molecular mimicry.

Molecular mimicry occurs when the proteins on the surface of the streptococcal bacteria are similar in structure to proteins found in certain tissues of the body, particularly in the heart, joints, and brain. When the immune system produces antibodies to fight the streptococcal infection, these antibodies may also mistakenly attack and damage the body’s own tissues, leading to the symptoms of rheumatic fever.

Not everyone who is infected with group A Streptococcus bacteria will develop rheumatic fever. Factors that may increase the risk of developing rheumatic fever include:

  1. Genetic Predisposition: Some individuals may be genetically predisposed to develop rheumatic fever in response to group A Streptococcus infection.
  2. Repeated Infections: Individuals who have had one episode of rheumatic fever are at increased risk of developing it again if they are reinfected with group A Streptococcus bacteria.
  3. Environmental Factors: Factors such as overcrowding, poor sanitation, and limited access to healthcare may increase the risk of streptococcal infections and, consequently, rheumatic fever.

It’s important to treat strep throat promptly with antibiotics to prevent the development of rheumatic fever. If you or someone you know has symptoms of strep throat, such as a sore throat, fever, and swollen lymph nodes, it’s important to see a healthcare provider for evaluation and treatment.

What is the treatment for rheumatic fever?

The treatment for rheumatic fever typically involves managing symptoms, reducing inflammation, and preventing further episodes of the disease. Treatment may include:

  1. Antibiotics: Antibiotics, such as penicillin or erythromycin, are used to treat the underlying streptococcal infection that triggered rheumatic fever. Antibiotic treatment is important to eliminate the bacteria and prevent further complications.
  2. Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, may be used to reduce inflammation, fever, and joint pain associated with rheumatic fever. Aspirin should not be given to children or teenagers with viral infections due to the risk of Reye’s syndrome.
  3. Corticosteroids: In cases of severe inflammation or involvement of the heart, corticosteroids, such as prednisone, may be prescribed to reduce inflammation and prevent damage to the heart valves.
  4. Bed Rest: Rest is often recommended during the acute phase of rheumatic fever, especially if there is inflammation of the heart (carditis) or joints.
  5. Heart Valve Surgery: In severe cases of rheumatic heart disease, where there is significant damage to the heart valves, surgery may be needed to repair or replace the damaged valves.
  6. Long-Term Antibiotics: Individuals who have had an episode of rheumatic fever are at increased risk of developing recurrent episodes. To prevent this, long-term antibiotic treatment may be recommended to prevent streptococcal infections and subsequent episodes of rheumatic fever.
  7. Treatment of Sydenham’s Chorea: Sydenham’s chorea, a neurological complication of rheumatic fever, may be treated with medications to help control the abnormal movements.
  8. Follow-Up Care: Regular follow-up appointments with a healthcare provider are important to monitor the heart and other affected organs and to adjust treatment as needed.

It’s important for individuals with rheumatic fever to receive prompt and appropriate treatment to reduce the risk of complications and long-term damage to the heart and other organs. Treatment should be tailored to the individual’s specific symptoms and medical history, and close monitoring is essential to ensure the best possible outcome.

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About the Author: John Scott

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