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Rheumatic Fever



Introduction

Rheumatic fever is an inflammatory disease that can develop as a rare complication of untreated or undertreated strep throat infection. Strep throat is caused by infection with group A streptococcus. Rheumatic fever is most common in children between the ages of 5 and 15 years, though it can develop in adults, and can cause damage to the heart, joints, the brain and spinal cord, and the skin.

Symptoms of rheumatic (roo-MAT-ik) fever generally appear within a few weeks after a strep throat infection. In the United States, most cases of strep throat don't lead to rheumatic fever. Even in untreated cases, only a small percentage of people with strep throat develop rheumatic fever.

There's no cure for rheumatic fever. But it can be prevented by prompt and complete treatment of a strep throat infection with antibiotics.

Permanent heart damage resulting from rheumatic fever is called rheumatic heart disease. Rheumatic fever commonly damages the heart valves (rheumatic carditis) and can interfere with normal blood flow through the heart.

Rheumatic fever isn't as common in the United States today as it was at the start of the 20th century, before the widespread use of the antibiotics. Outbreaks do occur periodically, however. Rheumatic fever is still common in developing countries.

Signs and symptoms

Signs and symptoms of rheumatic fever may include: To diagnose rheumatic fever, doctors generally look for evidence of a preceding strep throat infection, which is characterized by:
  • Sore throat.
  • Red and swollen tonsils.
  • Fever.
  • Fatigue.
  • Abdominal pain (in younger children).
  • Tender lymph nodes in the front of the neck.
  • Headache.
  • Muscle aches.
In some cases, the initial strep infection may not cause any symptoms.

Causes

The exact cause of rheumatic fever isn't clear. Medical research has focused on an abnormal immune system response to the antigens produced by specific types of streptococcal bacteria. In addition, researchers are studying whether some people have a greater genetic disposition for an abnormal immune system response to streptococcal antigens.

Treatment

The goals of treatment for rheumatic fever are to relieve symptoms, destroy the group A streptococcus and prevent future infection.

Treatment of rheumatic fever involves:
  • Antibiotics to treat the streptococcal infection and prevent recurrences. Your doctor may prescribe penicillin or another antibiotic to eliminate any remaining strep bacteria in the body. Usually, additional antibiotics must be taken for several to many years to prevent additional attacks of rheumatic fever. Without continued antibiotic treatment, recurrence of rheumatic fever is common during the first three to five years after the initial infection.
  • Other medications to ease the symptoms of the disease. To reduce heart and joint inflammation, your doctor may recommend specific doses of over-the-counter or prescription nonsteroidal anti-inflammatory medication. For severe heart inflammation, a corticosteroid medication, such as prednisone, can reduce the inflammation.
Prevention

The only known way to prevent rheumatic fever is to adequately treat strep throat infections with a full course of appropriate antibiotics.

Most of the time, a virus is the cause of a sore throat, and viruses don't lead to rheumatic fever. A sore throat with fever lasting more than 24 hours may indicate a strep infection. Only a small percentage of people with untreated strep throat will develop rheumatic fever. Prompt and complete treatment of strep throat with a full course of appropriate antibiotics can prevent strep throat from progressing to rheumatic fever.


Information obtained from National Institute of Health
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