Is this Rheumatic fever?😕

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Rheumatic fever is an inflammatory illness that develops when the strep infection or scarlet fever is not treated properly. Strep infection and scarlet fever are caused by the streptococcus bacteria.

The link between strep infection and rheumatic fever is not properly understood. It is believed that the bacteria trick the immune system into attacking its healthy tissues.

Usually, the body’s immune system targets the bacteria causing the infection but in rheumatic fever, the immune system mistakenly attacks healthy tissue, particularly in the heart, joints, skin and central nervous system which results in swelling of the tissues(inflammation).

It may cause permanent damage to the heart, including damaged heart valves and potentially leading to heart failure.

It mostly affects children aged 5-15 years but it can develop in younger children and adults.


Symptoms 

Symptoms usually result from the inflammation of the tissues but these may change during the disease. It usually occurs about 2-4 weeks after a strep throat infection.

These may include the following;

  • Fever
  • Painful and tender joints-particularly in the knees, ankles, elbows and wrists
  • Pain in a joint that migrates to another
  • Red, hot or swollen joints
  • Chest pain
  • Fatigue
  • A painless rash that is flat or slightly raised, with a ragged edge
  • Heart murmur
  • Jerky, uncontrollable body movements- most often in the hands, face and feet(Sydenham's Chorea)
  • Outbursts of unusual behaviour such as crying, or inappropriate laughing that accompanies the jerky body movements
  • Small, painless bumps beneath the skin


Risk factors

The following factors may increase the risk of getting rheumatic fever in children:

  • Genes
  • Specific types of streptococcus bacteria
  • Environmental factors: a greater risk of having a rheumatic fever is associated with poor sanitation, overcrowding and other conditions that support the spread of the bacteria among people


Complications that may arise…

Inflammation caused by the disease can last a few weeks to several months and this may cause long-term complications for some children.

One major complication is permanent damage to the heart known as rheumatic heart disease. This disease condition usually occurs years after the original illness.

Damage to the heart valves or other heart tissues can lead to atrial fibrillation or heart failure later in the child’s life.


When should your child see a doctor?

Make an appointment with your child’s physician if any of these symptoms of strep infection occurs:

  • Sore throat that comes suddenly
  • Pain when swallowing
  • Fever
  • Headache
  • Stomach pain, nausea and vomiting


How can it be treated?

Treatment usually depends on the age, symptoms and general health of the child. It also depends on the severity of the disease condition.

Treating Rheumatic fever often combines the following 3 things:

  1. Treatment for strep infection with antibiotics: Your child may need to take monthly doses of antibiotics to prevent recurring strep infections. This is to help prevent rheumatic fever from reoccurring and further damaging the body.
  2. Taking anti-inflammatory drugs to help reduce the swelling that occurs in the heart muscle. These also help to reduce joint pain.
  3. Bed rest: This depends on the severity of the disease. It ranges from 2-12 weeks.


How is it prevented?

The ONLY WAY to prevent your child from having a rheumatic fever is to treat strep throat infections or scarlet fever quickly and completely with a full course of appropriate antibiotics when they have it.


A concerned parent would ask…

How can I help my child live with this disease?

  -Having rheumatic fever increases your child’s risk of getting the disease again. This usually occurs during the first 3 years. The chance of its recurrence lessens with age and time.

  -Your child will need to take antibiotics every month after having the disease. These help to reduce the chance of having the disease again. Often by the time a child becomes 18, the antibiotic therapy may be stopped.

  -Close follow-up with your child’s paediatrician is needed.

Dr. favvy

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Disclaimer

The information on this site is for educational purposes only.

It should not be used as a substitute for medical care and advise of your paediatrician.

Always consult your physician or pharmacist before taking any action!!!

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