Rheumatic fever

Children between 5 and 15 years are most at risk, particularly if they experience frequent strep throat infections. Rheumatic fever is also more common in children who have a family history of the disease. There is an increased prevalence of rheumatic fever in the winter and spring, as strep throats occur more frequently during these seasons. Strep infections are contagious, but rheumatic fever is not.

Strep throat symptoms

Strep throat symptoms include fever, pain, redness and swelling of the throat and tonsils. Strep throat may produce mild or severe symptoms; however, in up to a third of cases, the underlying strep infection may not have caused any symptoms.

Rheumatic fever symptoms

Rheumatic fever gets its name from the symptoms that are similar to those of rheumatism. Symptoms usually start from one to five weeks after being infected with streptococcus bacteria. The following are the most common symptoms, although each child may experience symptoms differently:

• • Inflammation of the joints, including swelling, tenderness and redness over multiple joints

• • Small nodules or hard, round bumps under the skin

• • A change in the child’s neuromuscular movements (this is usually noted by a change in his or her handwriting and may also include jerky movements)

• • A pink rash with odd edges that is usually seen on the chest of the body or arms and legs

• • Fever

• • Weight loss

• • Fatigue

• • Stomach pains.

Symptoms of rheumatic fever may resemble other medical conditions. Always consult a doctor for a diagnosis.

Diagnosis

In addition to a complete medical history and physical examination, rheumatic fever has to be diagnosed by the child’s doctor according to medical criteria.

Major criteria include:

• • Inflammation of the heart

• • Inflammation of more than one joint

• • Unusual jerky movements, most often involving the face and hands

• • Small, painless bumps under the skin, often over bony areas

• • Skin rash.

Minor criteria include:

• • Fever

• • Pain in one or more joints

• • Previous inflammation of the heart.

The diagnosis of rheumatic fever can be made when two of the major criteria, or one major criterion plus two minor criteria are present along with evidence of a streptococcal infection.

Treatment

Specific treatment for rheumatic fever will be determined by the doctor based on:

• • The child’s overall health and medical history

• • Extent of the reaction

• • The child’s tolerance for specific medications, procedures or therapies

• • Expectations for the course of the reaction

• • Your opinion or preference.

Children with rheumatic fever are often treated in hospital, depending upon the severity of the disease. After suffering from rheumatic fever, the child will need medications on a monthly basis to help decrease the chance of developing rheumatic fever again. Usually by the time the child is 18 and the doctor feels that he or she is not at risk for developing heart disease, the antibiotic therapy may be stopped. Close follow-up with the child’s doctor is essential.

Complications

Depending on the severity of the initial attack of the disease on the heart, some children may develop heart disease. Physical activity and sports may be restricted in the child, based on the findings of the doctor.

Also, if the child had heart problems during the initial course of rheumatic fever, he or she will need to receive antibiotics before having dental work done. This helps decrease the chance of infection migrating to the heart during the dental procedure. Consult the child’s doctor for more information.

 

Sources

 

www.medicalnewstoday.com
www.nlm.nih.gov/medlineplus
www.urmc.rochester.edu

 

(Revised by M Collins)