Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever, infections caused by the bacterium Streptococcus pyogenes. Although it's now rare in developed countries due to widespread use of antibiotics, rheumatic fever remains a serious concern in many developing regions. Here are key aspects of rheumatic fever:
- Causes and Risk Factors:
- Rheumatic fever occurs in response to a strep throat or scarlet fever infection, particularly when these conditions are not properly treated with antibiotics.
- Children between the ages of 5 and 15 are most at risk, although it can occur in younger children and adults.
- Genetic factors may play a role, as some individuals may have a genetic predisposition that increases their susceptibility.
- Symptoms:
- Symptoms typically develop 2 to 4 weeks after a strep throat infection.
- Common symptoms include fever, painful and swollen joints (often in the knees, elbows, ankles, and wrists), chest pain, heart palpitations, fatigue, and shortness of breath.
- Other symptoms may include a red, lattice-like rash (erythema marginatum), small, painless nodules under the skin, and unusual, jerky movements (Sydenham chorea or "St. Vitus' dance").
- Diagnosis:
- Diagnosis is based on clinical examination, the presence of symptoms, and a history of recent strep infection.
- Laboratory tests (like throat culture and blood tests) and imaging tests (like echocardiography for heart involvement) can help in diagnosis.
- Complications:
- The most serious complication is rheumatic heart disease, where the inflammation causes lasting damage to the heart valves, potentially leading to heart failure and other cardiac problems.
- Recurrent episodes of rheumatic fever are possible, especially in the absence of appropriate antibiotic prophylaxis.
- Treatment:
- Treatment aims to eliminate the strep bacteria, relieve symptoms, control inflammation, and prevent recurrences.
- Antibiotics are used to treat the underlying strep infection and to prevent recurrence.
- Anti-inflammatory medications, like aspirin or corticosteroids, are used to reduce inflammation and fever.
- Bed rest may be recommended during the acute phase.
- Prevention:
- The primary prevention method is prompt and complete treatment of strep throat and scarlet fever with antibiotics.
- Long-term antibiotic prophylaxis may be recommended for individuals with a history of rheumatic fever to prevent recurrence, especially in those with heart valve damage.
- Public Health Impact:
- Rheumatic fever is a major cause of heart disease in children in many developing countries.
- Efforts to improve access to healthcare and promote early treatment of strep infections are key to preventing rheumatic fever and its complications.
Awareness and timely treatment of strep throat are crucial in preventing rheumatic fever. In areas where the disease is more common, public health initiatives focus on improving access to medical care and antibiotics.