Rheumatic Fever
Rheumatic Fever Causes
Rheumatic fever is caused by complications following a Group A streptococcal pharyngeal infection. Infections usually associated with Rheumatic fever are strep throat and scarlet fever, among others. Rheumatic fever is basically a systemic disease which affects the peri-arteriolar connective tissue. The main causal factor is believed to be cross-reactivity of antibodies following the infection.
Rheumatic Fever Definition
Rheumatic fever pertains to an inflammatory disease which develops as a consequence of complications from a Group A streptococcal infection (e.g. scarlet fever and strep throat, etc.). Rheumatic fever commonly affects children 6 to 15 years old.
Rheumatic Fever Diagnosis
Diagnosis is based on a set of standardized criteria first established in 1944 by physician T. Duckett Jones, MD. The confirmation of two major criteria, or one major and two minor criteria, where there is also evidence of a prior strep infection, can confirm diagnosis of rheumatic fever. JONES is used as a mnemonic to establish the major criteria: J for inflammation of the joints (usually migratory polyarthritis); a heart-shaped O for inflammation of the heart muscle (carditis); N for nodules containing firm collections of collagen fibers on the wrist, arms, and knees; E for erythema marginatum (persistent rash arising from the trunk and spreading outward in a snake-like pattern); and S for Sydenham's chorea (pertaining to a series of rapid involuntary movements). Minor criteria include fever, arthralgia, laboratory abnormalities (elevated sedimentation rate, high C reactive protein, leukocytosis), electrocardiogram abnormalities, evidence of group A strep infection, as well as evidence of previous rheumatic fever or inactive heart disease.
Rheumatic Fever Symptoms and Signs
Rheumatic fever causes an inflammation in the organ systems of the body, particularly the heart and joints. Symptoms vary according to which areas are affected and typically appear weeks after the disappearance of throat syndromes. Common manifestations include fever, chest pain, joint pain, palpitations, jerky movements, rashes, and small bumps on the skin.
Rheumatic Fever Treatment
Treatment of rheumatic fever is focused on reducing the characteristic inflammation with anti-inflammatory drugs such as corticosteroids and aspirin. Patients with positive strep throat cultures should be given antibiotics. Potential side effects and other complications should also be monitored closely and treated appropriately. Steroids may help avoid further scarring of the tissue. Antibiotics, of course, are a major factor in treatment. In addition, specific treatment should be geared towards managing infections, inflammations, and potential heart problems that may develop.