Rheumatic fever is a rare but potentially serious inflammatory condition that stands as a persistent health concern. It can typically develop as a complication of untreated or inadequately treated strep throat. It can cause fever, joint pain, and even cardiac issues. We spoke to our expert Dr Ravi Shankerji Kesari, MD – General Physician, Apollo Spectra Hospital, Bengaluru, who explained this condition, its symptoms, causes, and treatment measures.
“This condition predominantly affects children aged 5-15, though it can also occur in adults. Its intricate interplay between infection, immune response and systemic effects renders it a multifaceted condition that demands attention and understanding”, said Dr Kesari.
According to the Centers for Disease Control And Prevention, you may develop rheumatic heart disease if rheumatic fever is not treated right away. The heart's valves between its chambers deteriorate with rheumatic heart disease. Severe rheumatic heart disease can be fatal and necessitate heart surgery.
Symptoms of Rheumatic Fever
The symptoms of rheumatic fever can vary widely and affect different parts of the body. Dr Kesari listed some of the most common signs as follows:
- Fever and Joint Pain: Joint inflammation and pain often migrating from one joint to another are initial symptoms that might persist or recur. This migration typically involves larger joints like knees, elbows, ankles, and wrists.
- Cardiac Issues: Rheumatic fever can cause inflammation of the heart, leading to symptoms like chest pain, shortness of breath, heart palpitations and even damage to the heart valves.
- Skin Rash: Skin rashes, characterised by red, slightly raised and painless nodules under the skin or a rash with a ‘chequered’ appearance can be observed.
- Neurological Symptoms: In rare cases, rheumatic fever can affect the brain, leading to symptoms, such as involuntary movements, especially of the face and the limbs known as Sydenham's chorea.
- Fatigue and Weakness: Feeling tired and weak due to the overall impact on the body's immune system
Causes of Rheumatic Fever
“The primary cause of rheumatic fever is an untreated or poorly treated streptococcal infection, most commonly strep throat or scarlet fever, caused by Group A Streptococcus bacteria”, informed Dr Kesari.
When these infections aren't treated promptly with antibiotics, the bacteria can trigger an abnormal immune response in susceptible individuals. This response leads to the immune system mistakenly attacking healthy tissues, leading to inflammation and subsequent damage, primarily in the heart, joints, skin and brain.
Diagnosis Of Rheumatic Fever
Diagnosing rheumatic fever can be challenging due to its diverse manifestations and the need to rule out other conditions with similar symptoms. “The process involves a thorough evaluation of symptoms, medical history and cardiac assessments, such as echocardiography and conducting various blood tests to detect markers of inflammation and throat swabs to detect evidence of a prior streptococcal infection”, highlighted Dr Kesari.
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How To Treat Rheumatic Fever
Early diagnosis and prompt treatment are imperative to prevent complications. Dr Kesari listed the treatment measures as follows:
- Antibiotics: To eliminate any remaining streptococcal bacteria and prevent future infections antibiotics, particularly penicillin or other suitable alternatives are administered.
- Anti-Inflammatory Medications: In addition to antibiotics, anti-inflammatory medications like aspirin or corticosteroids can be prescribed to suppress the immune response, reduce inflammation, relieve pain and alleviate symptoms.
- Supportive Care: Rest, proper nutrition, and management of symptoms to support the body's healing process is necessary.
- Regular Follow-ups: Individuals diagnosed with rheumatic fever require long-term follow-up to monitor the recurrent episodes and to prevent potential complications, especially in the heart.
Prevention Of Rheumatic Fever
Preventing rheumatic fever primarily involves prompt and adequate treatment of streptococcal infections. Timely administration of appropriate antibiotics is pivotal in reducing the risk of developing rheumatic fever. Individuals who have had rheumatic fever are often advised to take long-term antibiotics to prevent recurring episodes.
Bottomline
Dr Kesari concluded, “Rheumatic fever, although considered rare in developed countries, continues to affect populations in certain regions, primarily due to inadequate access to healthcare and delayed treatment of streptococcal infections. Appropriate treatment and regular follow-ups are essential in managing symptoms, reducing inflammation and preventing complications, particularly damage to the heart valves.”
[Disclaimer: The information in this article is provided by a registered healthcare professional and is for informational purposes only. Hence, we advise you to consult your expert if you notice any symptoms to get the necessary treatment.]