Rheumatic Fever: Symptoms, Causes, Treatment

What are the symptoms of rheumatic fever?

Rheumatic fever is an inflammatory disease that can develop after an infection with Streptococcus bacteria, such as strep throat. The symptoms can vary but often include:

• Fever: A high temperature is a common symptom of rheumatic fever.
• Joint Pain and Swelling: This often affects large joints, such as the knees, elbows, ankles, and wrists, causing pain, redness, and swelling.
• Carditis: Inflammation of the heart, which can lead to symptoms like chest pain, shortness of breath, and heart murmurs. This can affect the heart valves and lead to long-term heart damage.
• Rash: A characteristic rash, known as erythema marginatum, appears as pink or red spots with a clear center and is often found on the trunk and limbs.
• Chorea: Also known as Sydenham’s chorea, this is a condition that involves uncontrolled, jerky movements, often affecting the face, hands, and feet.
• Subcutaneous Nodules: These are small, painless lumps that appear under the skin, typically over bony areas like elbows or knees.
• Fatigue: General feelings of tiredness and weakness can occur.
• Abdominal Pain: Some people may experience pain in the abdomen.

The symptoms usually develop about 2 to 4 weeks after a strep throat infection. Early diagnosis and treatment are crucial to manage rheumatic fever and prevent complications.

What are the causes of rheumatic fever?

Rheumatic fever is caused by an autoimmune response triggered by an infection with Group A Streptococcus bacteria, which causes strep throat or scarlet fever. The key points about its causes are:

• Streptococcal Infection: The primary cause is a previous infection with Group A Streptococcus bacteria. This typically occurs as strep throat or scarlet fever.
• Autoimmune Reaction: After the initial infection, the body’s immune system mistakenly attacks its own tissues, particularly the heart, joints, skin, and brain. This autoimmune reaction is what leads to the inflammation and symptoms associated with rheumatic fever.
• Genetic Factors: Genetic predisposition may also play a role. Some people may be more susceptible to developing rheumatic fever due to their genetic makeup.
• Environmental Factors: Poor living conditions, crowded environments, and lack of access to healthcare can contribute to higher rates of streptococcal infections and, subsequently, rheumatic fever.
• Delayed or Inadequate Treatment: Not adequately treating strep throat or scarlet fever with antibiotics can increase the risk of developing rheumatic fever.

Early and effective treatment of streptococcal infections with antibiotics is crucial in preventing rheumatic fever.

What is the treatment for rheumatic fever?

Treatment for rheumatic fever aims to reduce inflammation, manage symptoms, and prevent complications. The key components of treatment include:

• Antibiotics: To eliminate any remaining streptococcal bacteria and prevent recurrence of infection. Penicillin is commonly used, but other antibiotics may be prescribed based on individual needs.
• Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen are used to reduce inflammation, pain, and fever. In some cases, corticosteroids such as prednisone may be prescribed if NSAIDs are not effective or if there is severe inflammation.
• Management of Carditis: If the heart is affected (carditis), additional treatments may be required to manage heart inflammation and protect the heart valves. This might involve diuretics to reduce fluid buildup and other medications to support heart function.
• Chorea Management: If chorea (involuntary movements) is present, medications such as anticonvulsants or neuroleptics may help control the symptoms.
• Long-Term Antibiotic Prophylaxis: To prevent recurrent episodes of rheumatic fever, long-term antibiotic prophylaxis may be recommended, especially if there is significant heart involvement. This typically involves daily oral antibiotics or regular intramuscular injections of penicillin.
• Supportive Care: Rest and symptomatic treatment, including management of fever and joint pain, are important for overall recovery.
• Regular Follow-Up: Regular follow-up with a healthcare provider is crucial to monitor for complications, especially for heart involvement and to ensure adherence to preventive measures.

Early treatment of streptococcal infections and adherence to prescribed treatments are essential for preventing rheumatic fever and its complications.