Rheumatic Fever - A Life Threatening Children Disease

Rheumatic Fever - A Life Threatening Children Disease

Some infections if left untreated can turn into a life-threatening condition. We have to be extra cautious, especially, when it comes to diseases of the children. Rheumatic fever is one such complication that can occur due to untreated strep throat and scarlet fever.

What is rheumatic fever?

Rheumatic fever is a serious illness related to strep throat, causing severe complications such as stroke, permanent damage to the heart and even death, if left untreated. This condition typically affects children aged 5-15 which are more susceptible to strep infections, but it can also occur in adults.

What causes rheumatic fever?

Rheumatic fever occurs after coming in contact with the Streptococcus bacteria. This bacterium causes diseases such as scarlet fever, strep throat and cellulitis. If these conditions are left untreated, it can lead to rheumatic fever.

The link between rheumatic fever and strep throat is yet not clear, but it appears that the bacterium tricks the immune system. The strep bacterium carries a protein that is similar to a protein found in certain tissues of the body.

So when the body’s immune system responds to the attack of the bacterium, it treats the bacteria as body’s own tissue as if they are infectious agents, especially the tissues of skin, joints, heart and nervous system. This reaction of the immune system can result in inflammation, causing rheumatic fever.

Symptoms of Rheumatic Fever

Not all the cases of strep throat will turn into rheumatic fever. Also, the symptoms will depend on individual to individual. Typically, the onset of the symptoms starts 2-4 weeks after the strep infection. Some of the common symptoms are:

  • Sore throat
  •  Difficulty in swallowing
  •  Fever
  •  Swollen joints especially redness in ankles and knees
  •  Red rashes on chest, abdomen, and back
  •  Thick bloody discharge from the nose
  •  Swollen tonsils
  •  Headache
  •  Vomiting
  •  Nausea
  •  Chest pain
  •  Fatigue
  •  Jerky, uncontrollable movements of hands and feet
  •  Inappropriate laughter and sudden outbursts of crying

Risk Factors

There are some factors which can increase the risk of getting the disease. These are:

 Family history

Since it’s an autoimmune disease, it might be possible that some people inherit a gene which could become the reason for getting the disease at a later stage of life.

Strep bacteria type

Certain strains of strep bacteria can be more harmful than the other strains.

Environmental factors

Developing countries are at a greater risk since most of them are overcrowded, lacks clean water and don’t have proper sanitation.

Complications of Rheumatic Fever  

Rheumatic fever can result in long-term complications, the most severe of them is rheumatic heart disease. Other heart complications may include:

  • Narrowing of heart valve (valve stenosis)
  • Blood flowing in the wrong direction due to leakage in the valve
  • Inflammation causing damage to the heart muscles, further decreasing the ability of the heart to pump the blood effectively
  • Irregular beating of the upper chamber of the heart (atrial fibrillation)
  • Heart failure

How Rheumatic Fever is Diagnosed?

There isn’t any single test for diagnosing rheumatic fever. The doctor will first ask about medical history, perform some physical exam and then order some tests. These include:

  • Looking into hard bumps or rash and skin nodules which are usually under the skin
  • Checking the heart for any abnormalities
  • Movement tests to determine the functioning of the nervous system
  • Blood test for any strep bacteria
  • Throat culture by taking a sample of throat mucus
  • Rapid strep test that could give results in 5 minutes
  • Joints for any inflammation
  • Conduct electrocardiogram test to measure electric waves of the heart
  • Conduct echocardiogram test that uses ultrasound waves to produce visual images of the heart

Treatment of Rheumatic Fever

The aim of the treatment is to target the bacteria, relieve the person from symptoms and prevent further occurrence. Besides bed rest, the doctor would advise a patient to take:

Anti-biotics treatment

After the initial treatment with antibiotics, the doctor would start another course of small doses that would go for a long time, at least for 5 years. This is to prevent recurrence of the disease. People with inflammation of the heart might be advised to take the preventive antibiotic treatment for as long as 10 years.

Anti-inflammatory treatment

This treatment includes pain-relieving medication such as aspirin or naproxen that also serves the purpose for treating inflammation.

Anti-convulsant treatment

This type of medication is prescribed in case of involuntary movements.

Prevention Tips

The best way to prevent rheumatic fever is to pay utmost attention to a sore throat, especially of the children. If you see your child having a sore throat that lasts more than 2-3 days, you need to meet the doctor as it could be a strep throat infection or scarlet fever.

Some of the damage caused by rheumatic fever might not be visible until years. So it’s better to jump into action as quickly as possible.

Sources

1. Cilliers A.M.(2006).Rheumatic fever and its management. read more
2. Paotonu D.S.,et al.(2017, March). Acute Rheumatic Fever and Rheumatic Heart Disease. read more
3. Rheumatic fever(2017, December 21) 
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