Acute Rheumatic fever
by Dr. Md. Asaduzzaman
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Acute rheumatic fever is one of the complications associated with strep throat. The condition usually appears in children between the ages of 5 and 15, even though older children and adults have been known to contract the fever as well.
Acute rheumatic fever is a relatively serious illness that, if left untreated, can cause stroke, permanent damage to your heart, and death. According to Medical News Today, rheumatic fever is still a common illness in places like sub-Saharan Africa, south central Asia, and certain populations in Australia and New Zealand .
Etiology of Acute Rheumatic Fever
The number one cause of acute rheumatic fever is strep throat. However, it has also been associated with scarlet fever. The body will sometimes attack its own tissues after it’s been infected with the strep throat bacteria. This reaction will cause widespread inflammation through the body that is the basis for all of the symptoms of rheumatic fever.
Clinical feathers of Acute Rheumatic fever
Acute rheumatic fever is a complication of strep throat. If your child has any of the following symptoms, a strep test is needed:
sore throat or sore throat with tender and swollen lymph nodes
thick, bloody discharge from nose
A wide variety of symptoms are associated with rheumatic fever. An individual with the illness could experience a few, some, or most of the symptoms below. Symptoms usually appear two to four weeks after your child has been diagnosed with strep throat.
Common symptoms include
painful/tender joints in the ankles, knees, elbows, and wrists
pain in one joint that moves to another joint
red, hot, swollen joints
small nodules (bumps) under the skin that don’t hurt
rapid fluttering or pounding chest palpitations
shortness of breath
short attention span
flat, slightly raised, ragged rash
jerky uncontrollable hand, feet, face movements
outbursts of crying or inappropriate laughter
The following situations require that you seek medical advice and or attention:
fever that is over 100 °F in newborns to 6-week-old infants
fever that is 102 °F or higher in babies 6 weeks to 2 years old
fever that is 103 °F or higher in children age 2 years or older
fever that lasts more than three days
How to diagnose of rheumatic fever?
The doctor will first want to get your child’s medical history, including his or her current symptoms. The doctor will also want to know if your child has had a recent bout of strep throat. Next, a physical exam will be given that includes the following:
checking joints for inflammation
looking for rash or skin nodules (hard bumps beneath the skin)
listening to heart to check for abnormalities
movement tests to determine nervous system dysfunction
blood tests for strep bacteria
EKG (measures the electric waves of the heart)
echocardiography (uses sound waves to produce image of the heart)
Effective Treatments for Rheumatic Fever
The most effective way to make sure that your child does not contract rheumatic fever is to make sure all strep bacteria are killed. In addition, doctors will treat the symptoms and control resulting inflammation. This can include any of the following.
Doctors will prescribe antibiotics and, on occasion, will prescribe a long-term (up to five-year) treatment to prevent reoccurrence.
Anti-inflammatory treatments include pain relief medications that are also anti-inflammatory, such as aspirin or naproxen. Doctors may also prescribe a corticosteroid (a class of drug that decreases inflammation).
Your doctor might prescribe an anticonvulsant if involuntary movements become too severe.
Doctors will also recommend bed rest and restricted activities until the major symptoms like pain and inflammation have passed. Your child might be placed on strict bed rest for a few weeks to a few months if the fever has caused heart problems.
Factors That Can Increase the Risk of Catching Acute Rheumatic Fever
Certain factors can increase the chances of your child developing Acute rheumatic fever. These include:
certain genes make it more likely to develop acute rheumatic fever
type of strep throat bacteria present—certain strains are more likely to lead to acute rheumatic fever than others
environmental factors present in developing countries, including poor sanitation, overcrowding, and lack of clean water
How to Prevent Rheumatic Fever
The best way to prevent rheumatic fever is to fully treat all strep throat and scarlet fever infections. Make sure your child completes all prescribed doses of medication. In addition, schedule a follow-up visit to ensure that your child is free from the strep bacteria antibodies.
Complications Associated with Acute Rheumatic Fever
Once they develop, the symptoms of acute rheumatic fever can last for months. Acute rheumatic fever can cause long-term complications in certain situations. One of the most prevalent complications is rheumatic heart disease. Other heart conditions include:
a narrowing of the valve
valve regurgitation—a leak in the valve that causes blood to flow in the wrong direction
heart muscle damage—inflammation can weaken the heart muscle, which can decrease the heart’s ability to pump blood effectively
atrial fibrillation—irregular heart beat (in the upper chambers)
heart failure—heart can no longer pump blood to all parts of the body
The long-term effects of rheumatic fever can be disabling if your child had a severe case. Some of the damage caused by the illness might not show up until years later. Be aware of long-term effects as your child grows older. Children who suffer from the long-term damage related to rheumatic fever may be eligible for special treatment of medicine.
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