Mmmm...Rheumatic fever????

RHEUMATIC FEVER

Definition
Rheumatic fever is inflammation of the body's organ systems, especially the joints and the heart, resulting from a complication of streptococcal infection of the throat. Rheumatic fever can affect many connective tissues of the body, nervous system and skin. Permanent heart damage from rheumatic fever is called rheumatic heart disease.

Signs and symptoms
Symptoms of rheumatic fever generally appear within five weeks after an untreated strep throat infection. The most common symptoms of rheumatic fever are:
Fever
Joint pain, migratory arthritis -- involving primarily knees, elbows, ankles, and wrists
Joint swelling
Abdominal pain
Skin rash
Skin eruption on the trunk and upper part of arms or legs
Eruptions that are ring-shaped or snake-like in appearance
Skin nodules
Sydenham's chorea ( jerky uncontrollable movements )
Nosebleeds
Shortness of breath
Chest pain
Sore throat
Red and swollen tonsils
Headache
Muscle aches

Causes
The exact cause of rheumatic fever isn't clear. In a few people, it seems that when the body fights a strep throat infection, other parts of the body develop inflammation. For example, the heart valves aren't necessarily infected with the streptococcal bacteria, but they can be injured or inflamed as the body fights strep throat.

Diagnosis
Bases the diagnosis of rheumatic fever mainly on the characteristic combination of symptoms. Diagnosing rheumatic fever requires not only the presence of key signs and symptoms but also evidence of a recent strep infection. Blood tests showing high levels of antibodies to streptococci may be helpful, but low levels of these antibodies are present in many children who do not have rheumatic fever. Abnormal heart rhythms caused by heart inflammation can be seen on an electrocardiogram (ECG—a recording of the heart's electrical activity). An echocardiogram (an image of structures in the heart produced by ultrasound waves) may be used to diagnose abnormalities of the heart valves.

Complications
Some common complications of rheumatic fever are:
« Damage to heart valves
« Endocarditis
« Heart failure
« Arrhythmia
« Pericarditis
« Permanent heart damage due to rheumatic fever is known as rheumatic heart disease

Prevention and Treatment
The best way to prevent rheumatic fever is with prompt and complete antibiotic treatment of any streptococcal throat infection. In addition, children who have had rheumatic fever should be given penicillin by mouth every day or by monthly injections into the muscle to help prevent another streptococcal infection. How long this preventive treatment should be continued is unclear. It depends on the severity of the disease and is usually continued at least until adulthood.
Treatment of rheumatic fever has three goals: eliminating any residual streptococcal infection; reducing inflammation, particularly in the joints and heart, and thus relieving symptoms; and limiting physical activity that might aggravate the inflamed structures.