Rheumatic Fever
Rheumatic Fever on it's own may or may not be an
autoimmune condition. RF is an inflammatory usually
is caused by a poorly treated or untreated infection
such as Strep, and so the antibodies begin attacking
other areas, usually the heart, and can leave serious,
permanent damage, including a narrowing of the heart
valve (Valve stenosis), a leak in the valve that allows
the blood to flow the wrong direction (Valve regurgitation)
or inflammation to the heart muscle. Some of the damage
may be permanent.
Initial symptoms of Rheumatic Fever might include
a fever, joint pain with swelling and redness, nose
bleeds, and skin rashes.
Rheumatic Fever is rare in the United States in recent
years, but there is still an occasion where a case
of Rheumatic Fever does occur. It typically occurs
in children between the ages of 6-15, and usually
within 20 days of strep throat or scarlet fever. The
reason it is so rare in the U.S. and other developed
countries is because the treatment of Strep and other
infections are usually effective enough to take care
of the infection, and not give Rheumatic Fever the
chance to set in.
Symptoms:
Abdominal pain
Bleeding from the nose
Fever
General joint pain and stiffness
Nodules under the skin
Shortness of breath
Diagnosis:
To diagnose Rheumatic Fever, your physician begins
with the typical exam and symptom history, as well
as history of recent infections. They may also perform
an electrocardiogram to check your heart. Blood tests
may show:
Elevated Erythrocyte Sedimentation Rate
Elevated C-Reactive Protein
Elevated White Blood Cell Count
Elevated Leukocytes
Elevated Antistreptolysin O Titre
There is also certain criteria that must be met before
a physician can confirm a Rheumatic Fever diagnosis,
broken down into Major Criteria and Minor Criteria.
(source: UW
Health)
Major Criteria:
- Arthritis in several joints (polyarthritis)
- Heart inflammation (carditis)
- Nodules under the skin (subcutaneous skin nodules)
- Rapid, jerky movements (chorea, Sydenham chorea)
- Skin rash (erythema marginatum)
Minor Criteria:
- Fever
- High ESR
- Joint pain
- Other laboratory findings
Treatment:
The goal of treatment is to destroy the strep bacteria
or other bacteria causing the Rheumatic Fever, while
relieving the symptoms of inflammation. Preventative
measures might also be taken in order to control relapses
of the Rheumatic Fever.
The treatment may include antibiotics, and in severe
cases the antibiotic will be continued even after
the offending bacteria is gone to prevent a relapse.
Non-steroidal anti-inflammatories might be used to
reduce inflammation.
Prognosis:
Heart damage from the Rheumatic Fever may not show
up for years, so it is very important that you follow
up with your physician regularly. For at least the
first 3-5 years, low-dose antibiotics will more than
likely be taken for prevention. If low-dose antibiotics
are not taken, Rheumatic Fever will relapse.
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