Rheumatic fever is a complication of throat infection caused by Group A Beta-Hemolytic Streptococcus bacteria or after scarlet fever, which develops in some people due to the body’s overreaction to the bacteria and progresses with joint pain and heart problems.
The bacteria that cause it and the infectious diseases it causes are contagious, but rheumatic fever is not contagious. It is more common in winter and spring.
If not treated properly, it can leave permanent damage to the heart. Apart from the heart, there may also be brain and skin problems. Signs and symptoms other than the heart are temporary.
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Risk groups:
- Family history of rheumatic heart disease
- Those who have heart valve disease or have undergone valve operation related to it,
- Those who have relatives in the family who have regular penicillin injections,
- 5-14 years old children,
- Those who suffer from frequent tonsillitis or scarlet fever.
Symptoms:
- Migratory joint pain, swelling, redness in the joints (usually ankles, knees, wrists, elbows), occurring 2-3 weeks after throat infection,
- Don’t get tired quickly,
- Gait disturbance,
- Subcutaneous swellings in the joints,
- Skin rash, swelling,
- Flat or slightly raised, irregular-edged, painless rash (erythema marginatum),
- Involuntary muscle movements
- Uncontrollable body movements that occur most frequently in the hands, feet and face, impaired handwriting of the child (Sydenham Korea),
- Heart rhythm disorders,
- Increase in heart rate,
- Pale red spots on the arms or abdomen.
Diagnosis:
The patient’s past throat infection and scarlet history are questioned. In the examination, signs and symptoms of the disease are investigated.
In blood tests, complete blood count, CRP (C-reactive protein), sedimentation and antibody levels (ARO) are checked.
ECG and ECO tests are performed on the patient and cardiac functions are evaluated.
Treatment:
The signs and symptoms of the disease improve within a few weeks to a few months, but permanent damage to the heart may occur.
Disease treatment consists of two stages: treatment of active disease and preventive treatment for the prevention of possible heart damage after the active period.
Treatment of active disease:
To alleviate the patient’s signs and symptoms, to relieve acute inflammation:
- Antibiotic treatment (penicillin or similar drugs) is applied,
- Painkillers (NSAIDs) can be given,
- Steroid therapy can be supportive in severe pain.
- Anticonvulsant drugs (valproic acid, carbamazepine, etc.) can be given for uncontrollable movements.
- Plenty of bed rest is recommended.
Preventive treatment:
After the acute illness period, preventive treatment is recommended in order to prevent the risk of developing heart disease in the patient. For this, preventive antibiotic therapy is given for at least 5 years or until the age of 21. The duration is 10 years in those with heart involvement. Penicillin is mostly preferred in preventive treatment.
It is recommended to have regular check-ups in terms of heart disease after preventive treatment.