Imagine your child has a sore throat and it gets better in a few days. But after a week or two, your child has a fever again, along with swollen joints like the knees and ankles, and severe pain. Sometimes this pain moves from one joint to another. Have you had this experience? This is not something to just ignore. It could be rheumatic fever, a serious condition that occurs when a throat infection is left untreated. Let's talk about it all today.
What exactly is Rheumatic Fever?
Simply put, rheumatic fever is a serious reaction to
an untreated throat infection (Strep Throat) . This throat infection is caused by a bacteria called 'group A streptococcus'. When this bacteria is not treated properly, our body's immune system goes haywire. This means that the antibodies that act like body defenses start
attacking not only the bacteria but also our own tissues, especially the joints, heart, and skin . The biggest danger of this is the damage to the heart. More than half of people who develop rheumatic fever have damage to their heart valves. This makes the heart work harder to pump blood. Over time, this damage can lead to a condition called
rheumatic heart disease , which can eventually lead to heart failure. Sometimes, rheumatic fever can cause a temporary condition called Sydenham's chorea, which affects the nervous system. This can cause the muscles in the body, limbs, and face to twitch uncontrollably.
The important thing is that rheumatic fever is not a contagious disease. However, the streptococcus bacteria that causes it ( sore throat ) can be transmitted from person to person.
What are the main symptoms of rheumatic fever?
These symptoms usually appear between 1 and 5 weeks after a sore throat. Sometimes a sore throat can be mild, meaning it can come and go without any major symptoms. So some people may not even remember having a sore throat.
| Symptom | Description |
|---|
| Swollen, painful joints | Joints, especially the knees, ankles, elbows, and wrists, become swollen, red, and painful. This pain can move from one joint to another. |
| Fever | Fever that comes without a reason. |
| A skin rash | The appearance of a red, slightly raised, welt-like rash on the chest, back, or abdomen. |
| Lumps under the skin (Nodules) | Small, painless lumps appear under the skin near swollen joints, especially in places like the elbows. |
| Heart-related symptoms | Chest pain, rapid heartbeat, and difficulty breathing are signs that the heart has been affected. |
| Uncontrollable movements (Chorea) | Uncontrolled twitching movements of the arms, legs, or face. |
Take care of a child's sore throat
Don't take a child's sore throat lightly. Especially
if they have a severe sore throat and a fever (over 100.4 F / 38 C) without other symptoms of a cold (such as runny nose, sneezing) , and if their sore throat lasts more than two or three days,
you should definitely see a doctor . It could be a strep throat infection. If so, it's important to get the right antibiotics to treat it completely.
Who is most at risk?
Although anyone who has a streptococcal infection can develop rheumatic fever, some people are more susceptible to it.
- Children between the ages of 5-15.
- People in crowded places like schools and daycare centers.
- If a person who has previously had rheumatic fever develops a streptococcal infection again.
How do you find this, Doctor?
When you go to see a doctor, he will first listen carefully to your symptoms. Then he will do a physical examination. 1.
Throat Culture: A small swab is taken from the inside of your throat to check for strep bacteria and send it to the lab. 2.
Physical Examination: The doctor will listen to your heart with a stethoscope to check for any abnormal sounds (heart murmurs). He will also check for swelling in your joints, skin lesions, or lumps. 3.
Other Tests:- Blood tests : Antibody levels are checked to determine if there has been a recent streptococcal infection.
- ECG (Electrocardiogram): Tests the heart's function and electrical activity.
- Echo (Echocardiography): A scan that allows you to see the heart's muscles, valves, and pumping action like a video.
What are the treatments?
If rheumatic fever is confirmed, treatment has two main goals. One is to control the current symptoms. And the other, and most importantly,
to prevent long-term damage to the heart.- Antibiotics : An antibiotic such as penicillin is given to completely kill any remaining streptococcus bacteria in the body. You may also need to take low doses of antibiotics for years, or even your entire life, to prevent the disease from coming back.
- Pain and swelling medications: Medications like aspirin and ibuprofen are prescribed to control joint pain , swelling, and fever.
- Corticosteroids: These medications are given to control swelling if the heart has been affected.
- Complete rest: It is essential to get plenty of rest until the symptoms subside.
- Surgery: Rarely, if the heart valves are severely damaged, surgery may be needed to repair or replace them.
If you have rheumatic heart disease, you may need to take antibiotics before certain surgeries, such as tooth extractions, to prevent infection of the heart valves. Your doctor will advise you about this.
Long-term effects and complications
The most dangerous aspect of rheumatic fever is its long-term effects on the heart. This damage can occur even years after the disease has developed.
Major damage that can occur to the heart
| Valve stenosis | A narrowing of a heart valve restricts the flow of blood through it. |
| Valve regurgitation | The valve does not close properly, so blood flows backward. |
| Heart muscle damage | The swelling caused by rheumatic fever weakens the heart muscle and reduces its pumping ability. |
| Irregular heartbeat `(Atrial fibrillation)` | Damage to the valves and other parts of the heart causes irregular heartbeats. |
Take-Home Message
- Rheumatic fever is a serious consequence of untreated strep throat, a throat infection caused by the Streptococcus bacteria.
- If your child has a severe sore throat with a fever, don't simply ignore it and seek medical advice immediately.
- The most dangerous complication of rheumatic fever is long-term damage to the heart, known as rheumatic heart disease.
- Although this disease is not contagious, the throat infection that causes it can be contagious.
- If you have rheumatic fever, it is essential to take long-term treatment as directed by your doctor to prevent recurrence and protect your heart.
Rheumatic fever, joint pain, throat infection, streptococcus, rheumatic heart disease, pediatric diseases, heart disease
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