What is rheumatic fever? Rheumatic fever is a rare, autoimmune inflammatory condition that primarily affects children between the ages of 5 and 15. It occurs when the body’s immune system responds excessively to an untreated infection caused by group A streptococcus bacteria, such as strep throat or scarlet fever. The inflammation from rheumatic fever can cause long-term complications, impacting the heart, joints, brain, and skin.

Causes

The primary cause of rheumatic fever is an untreated infection from group A streptococcus bacteria, often stemming from strep throat or scarlet fever. When the body’s immune system reacts excessively to these infections, it can lead to the inflammation characteristic of rheumatic fever¹².

Symptoms

The symptoms of rheumatic fever may appear about two to three weeks following a strep infection and can include:

Red rash
Feeling tired all the time (Fatigue)
Difficulty swallowing
Unexplained or ongoing headaches
Thick, bloody discharge from the nose
High temperature (101°F or 38.3°C and above)
Red and swollen tonsils, sometimes with white patches or pus
Small, red spots on the skin
Joint pain, especially in the knees, wrists, elbows, and ankles
Involuntary jerky movements
Heart problems, including heart murmur and enlargement of the heart³⁴.

Diagnosis

Diagnosing rheumatic fever involves a thorough medical history, a physical examination, and certain tests to check for inflammation and other markers. There isn’t a single definitive test for rheumatic fever, making the diagnosis process reliant on a combination of symptoms, history of strep infection, and test results.

Treatment

Treatment aims to eradicate the underlying streptococcal infection, manage symptoms, and prevent recurrent episodes that could lead to rheumatic heart disease. It often includes:

Antibiotics to treat the streptococcal infection
Anti-inflammatory medications to manage inflammation and reduce joint pain
Medications to control involuntary movements if chorea is present
Long-term antibiotic prophylaxis to prevent recurrence in individuals at risk⁵⁴.

Prevention

Prevention primarily revolves around promptly recognizing and treating strep throat and other group A streptococcal infections with antibiotics to prevent the onset of rheumatic fever. Additionally, individuals who have had rheumatic fever before may need long-term antibiotic prophylaxis to prevent recurrence. Ensuring good hygiene practices like regular hand washing can also help in reducing the risk of strep infections.

Complications

Rheumatic fever can lead to long-term complications if not treated, including rheumatic heart disease, which is a condition where the heart valves are damaged. It can also cause permanent joint damage, neurological disorders, and skin problems.