Rheumatic Fever

What is rheumatic fever?

Rheumatic fever is a inflammatory condition which occurs after an tonsillitis caused by a specific bacteria (specifically, a group A Streptococcus). Rheumatic fever commonly affects the joints and heart. Rheumatic fever can cause many different symptoms, but the most common symptoms are fever and pain and swelling of the joints. Other symptoms are chest pain, cough, shortness of breath, involuntary movements (chorea) and rash. Rheumatic fever is treated with antibiotics. Some children with rheumatic fever may go on to develop problems with their heart valves.

Risks

Rheumatic fever has become rare in many countries because the underlying disease, a bacterial infection of the tonsils, can be treated with antibiotics. It still tends to be common in parts of the world where there is little access to medical care and crowded conditions. This condition tends to affect children between the ages of 5 and 15, and is rare in adults. Children who are not properly treated for bacterial tonsillitis are at higher risk of this condition.

Symptoms

Symptoms develop within 10-20 days after a bacterial infection of the tonsil or throat. They include fever, headache, weakness, a non-itchy rash and joint pain which mostly affects larger joints and spreads from one joint to another. Later, involuntary muscle movements may occur. Some people may develop carditis (inflammation of the heart muscle), which causes chest pain, cough and shortness of breath.

Diagnosis

Diagnosis is based on the symptoms and physical examination. Blood tests that show signs of inflammation support the diagnosis. Examination of the heart with electrocardiography (ECG or EKG) and ultrasound scans might also be necessary.

Treatment

The bacterial infection is treated with antibiotics. The symptoms of rheumatic fever can be reduced with anti-inflammatory medications and, if needed, steroid tablets. If the rheumatic fever involves the heart, long-term antibiotics might be prescribed.

Prevention

Seeing a doctor for tonsillitis and completing a whole course of antibiotics is important in preventing rheumatic fever. Having the tonsils removed after an episode of rheumatic fever may help to prevent future episodes of strep throat and recurrence of rheumatic fever.