Rheumatic Fever: Causes, Symptoms, and Treatment
Definition
Rheumatic fever is an inflammatory disease that can develop as a complication of untreated or poorly treated strep throat or scarlet fever. It primarily affects children and young adults, leading to serious damage to the heart, joints, skin, and brain.
Causes & Risk Factors
Rheumatic fever is caused by a bacterial infection with Group A Streptococcus. Risk factors include:
- History of strep throat or scarlet fever
- Age (commonly affects children between 5 and 15 years old)
- Crowded living conditions
- Poor access to healthcare
- Genetic predisposition
Pathophysiology
The pathophysiology of rheumatic fever involves an autoimmune response triggered by the Group A Streptococcus bacteria. The body's immune system mistakenly attacks its own tissues, causing widespread inflammation, particularly in the heart, joints, skin, and central nervous system.
Symptoms
Symptoms of rheumatic fever can vary widely but often include:
- Fever
- Painful and swollen joints (often knees, ankles, elbows, and wrists)
- Red, hot, or swollen joints
- Small, painless nodules under the skin
- Chest pain and heart murmurs
- Fatigue
- Skin rash
- Uncontrolled movements of arms, legs, or facial muscles
- Behavioral changes
Diagnosis
Diagnosis of rheumatic fever is based on a combination of medical history, physical examination, and laboratory tests. The Jones Criteria are commonly used, which require the presence of major and minor criteria such as arthritis, carditis, and evidence of a recent streptococcal infection.
Management & Treatment
Treatment of rheumatic fever aims to eradicate the streptococcal infection, reduce inflammation, and manage symptoms. Common medications include:
- Antibiotics (e.g., penicillin) to eliminate the bacterial infection
- Anti-inflammatory drugs (e.g., aspirin, corticosteroids) to reduce inflammation
- Anticonvulsant medications for severe chorea (involuntary movements)
Long-term management may involve continuous antibiotic prophylaxis to prevent recurrence.
Complications
If left untreated, rheumatic fever can lead to serious complications such as:
- Rheumatic heart disease, which can cause permanent damage to heart valves
- Heart failure
- Atrial fibrillation
- Stroke
Prevention
Preventing rheumatic fever involves promptly treating strep throat and scarlet fever with appropriate antibiotics. Public health measures to improve living conditions and access to healthcare can also help reduce the incidence of rheumatic fever.
FAQs
What causes rheumatic fever?
Rheumatic fever is caused by an infection with Group A Streptococcus bacteria, which leads to an abnormal immune response.
Who is at risk for rheumatic fever?
Children between the ages of 5 and 15 are most at risk, especially those living in crowded conditions or with limited access to healthcare.
Can rheumatic fever be cured?
While there is no cure for rheumatic fever, early treatment with antibiotics and anti-inflammatory medications can effectively manage symptoms and prevent complications.
Is rheumatic fever contagious?
Rheumatic fever itself is not contagious, but the streptococcal bacteria that cause it can be spread from person to person.
How is rheumatic fever diagnosed?
Rheumatic fever is diagnosed using a combination of medical history, physical examination, and laboratory tests, often guided by the Jones Criteria.