Does your child have these symptoms? Let's learn exactly what rheumatic fever is!

Does your little one often suffer from a sore throat and fever? Sometimes we think it's just a common cold. However, if not treated properly, some throat infections can lead to unexpected complications. Rheumatic Fever is one such unexpected, but potentially serious condition. Let's talk about this in detail today, because it's very important to be aware of it.

What is Rheumatic Fever? Simply put...

Simply put, rheumatic fever is a disease that occurs due to a malfunction in our own body's immune system. Doctors also call it ``acute rheumatic fever''. Imagine, your child has a throat infection, such as strep throat or scarlet fever , and this problem starts if it is not treated properly.

Both strep throat and scarlet fever are caused by a bacteria called Group A Streptococcus . They usually get better quickly with antibiotics. However, if left untreated, when a child's immune system fights the bacteria, it sometimes mistakenly attacks its own healthy tissues and organs. This causes inflammation and swelling in various parts of the body. This can affect the child's joints, heart, and blood vessels.

What is the difference between Scarlet Fever and Rheumatic Fever?

This is something that many people confuse. Scarlet fever and strep throat are both infections caused by group A streptococcus bacteria. These are treated with antibiotics.

Rheumatic fever is a very rare complication that can occur if an infection, such as scarlet fever or strep throat, is not properly treated. That is, not all strep throats progress to rheumatic fever.

How common is rheumatic fever?

In developed countries like the United States, strep throat is common, but rheumatic fever is not. Because antibiotics are readily available in those countries, many people get treatment for strep throat and scarlet fever quickly. When treated, rheumatic fever is prevented.

However, in countries like ours, especially in areas with limited medical facilities, this rheumatic fever situation can still be seen. Therefore, we need to be very careful about this.

What are the symptoms of rheumatic fever?

The way rheumatic fever affects each person can be different. Sometimes a strep infection can be so mild that you may not even know you have it until you develop rheumatic fever.

Rheumatic fever symptoms can often be difficult to recognize because they are similar to other health problems. But it's important to know what these symptoms are. Because rheumatic fever can be serious, if you suspect your child has these symptoms, you should see a doctor right away.

Here are some common symptoms that can be seen:

• Joint swelling, redness, and pain (arthritis): Joints like the knees, ankles, and elbows are especially painful. The pain may be in one joint one day and move to another joint the next day.
• Uncontrollable jerking of the limbs (chorea): The child may feel as if their arms, legs, or other parts of the body are suddenly jerking uncontrollably. This is also called ``Sydenham's chorea''.
• Small lumps under the skin (nodules): Sometimes small, hard lumps can develop under the skin, which can be felt in the hand. These are usually painless.
• Chest pain or heart rate abnormalities: You may feel a chest pain, or you may feel a change in the rate of your heart beating.
• Constant fatigue: The child may feel tired and sleepy all the time, even without doing anything.
• Fever: The body may become hot and fever may occur.
• Persistent headaches for no reason: Be concerned if a child who has not previously complained of a headache has persistent headaches.
• Muscle pain: You may feel like your muscles are aching.
• Swollen, red tonsils: The tonsils in the throat may be swollen and red.
• Red patches on the skin (erythema marginatum): Sometimes red, flat, round-edged patches can appear on the skin. These may come and go and come back.

Remember, having one or more of these symptoms doesn't necessarily mean you have rheumatic fever. However, if you have any doubts, it's best to see a doctor.

What causes rheumatic fever?

As we've discussed before, rheumatic fever is an overactive immune system that attacks healthy tissue. The main cause of this is an untreated strep throat or scarlet fever infection. That is, not receiving the appropriate antibiotics for the group A streptococcus bacteria infection.

What happens then is that when the body's defenses (antibodies) fight the bacteria, they mistakenly attack the body's own healthy tissues and organs. Think of it like when you're fighting an enemy, you think one of your own is an enemy and attack it.

Who gets rheumatic fever?

Although anyone can get rheumatic fever, it most often affects children and young adults between the ages of 5 and 15.Rheumatic fever symptoms usually appear two to three weeks after an untreated case of strep throat or scarlet fever. It is rare in children under 5 years of age and in people over 15 years of age.

How likely is it to develop rheumatic fever from strep throat or scarlet fever?

Not everyone who has strep throat or scarlet fever will develop rheumatic fever. It only happens if the infection is left untreated. However, in countries like the United States, rheumatic fever is very rare.

Who is at higher risk of developing rheumatic fever?

Some factors may increase your risk of developing rheumatic fever. Here are some of them:

• Where you live: Many people with rheumatic fever live in remote areas with limited medical facilities. Children who live in areas where it is difficult to get medicine or see a doctor are at higher risk.
• Age: As we said before, children between the ages of 5 and 15 are most affected.
• Overall health: A child with a weakened immune system may be at increased risk. Children who have frequent strep infections are also more likely to develop rheumatic fever.
• Family history: If someone in the family has had rheumatic fever before, other family members have a higher chance of developing it too.
• Crowded places: Bacteria spread easily in places where people gather together. Examples include schools and boarding schools.

Can adults get rheumatic fever?

It's very rare, but adults can also get rheumatic fever.

Is rheumatic fever contagious?

No, rheumatic fever is not contagious. You cannot catch it from someone else, nor can you spread it to someone else.

But, remember! Strep throat and scarlet fever, which are the causes of rheumatic fever, are contagious. They are spread through respiratory droplets when someone coughs or sneezes.

How does rheumatic fever affect the heart?

Rheumatic fever does not always affect the heart. However, if it does, it can damage the heart tissue, especially the heart valves. This damaged, scarred heart tissue does not work properly. Over time, rheumatic fever can cause permanent heart damage. Doctors also call this condition Rheumatic Heart Disease or Congestive Heart Failure .

If rheumatic fever somehow damages a heart valve, your doctor may recommend surgery to repair the damaged valve or to replace it with a new one. Sometimes, heart damage can occur 10 to 20 years after rheumatic fever. Therefore, it is important to stay in touch with a doctor you trust.

Can rheumatic fever cause rheumatoid arthritis?

Although some of the early symptoms of rheumatic fever are similar to rheumatoid arthritis (RA) , the two diseases are not related. Both diseases can affect a child's joints. However, rheumatic fever usually resolves within a few weeks, while RA is a lifelong condition. Children under the age of 16 are diagnosed with a condition called ``Juvenile Idiopathic Arthritis`` instead of RA.

How is rheumatic fever diagnosed? (Diagnosis)

If your child has a sore throat for more than two or three days, be sure to see a doctor. Prompt treatment for a group A streptococcal infection can help prevent rheumatic fever.

If the doctor suspects rheumatic fever, he or she will first take a throat swab from the child's throat to check for the presence of group A streptococcus bacteria. This may be done using a rapid strep test or a throat culture .

• Rapid strep test: Results can be obtained within 10 minutes.
• Throat culture: Results take a few days to come back. However, sometimes rapid strep tests can give ``false-negative results'' (meaning they show strep when it's not there).

What other tests are done to diagnose rheumatic fever?

Depending on the child's symptoms, the doctor may order further tests:

• Blood tests: Sometimes a blood test is done to confirm a strep infection. Although the test does not detect the bacteria, it can check for antibodies in the blood. It can also check for inflammation in the body by measuring certain proteins (such as CRP and ESR).
• Heart tests: These tests help to see how your baby's heart is working. This may include an ECG (electrocardiogram) or an Echocardiogram (an ultrasound of the heart, also called an Echo) .

What are the Jones criteria for rheumatic fever?

Doctors sometimes use a method called the Jones criteria to diagnose rheumatic fever. To be diagnosed with rheumatic fever, a child must have two major criteria , or one major and two minor criteria, from the following lists. In addition, there must be laboratory evidence of a previous group A streptococcal infection.

Major criteria:

• Arthritis of several joints
• Carditis
• Lumps under the skin (`nodules`)
• Rapid, jerky movements (chorea)
• Specific skin spots (erythema marginatum)

Minor criteria:

• Fever
• Increased blood levels of `ESR (erythrocyte sedimentation rate)` or `CRP (C-reactive protein)`
• Joint pain (arthralgia)
• ECG (electrocardiogram) changes
• Having a history of previous rheumatic fever or rheumatic heart disease

How is rheumatic fever treated?

When treating rheumatic fever, the first focus is on eliminating the bacterial infection. Then, treatment is given to reduce the inflammation in the child's body.

Treatments for rheumatic fever may include:

• Antibiotics: First, doctors prescribe antibiotics to treat the underlying bacterial infection. Some antibiotics are given as a single injection. Others are taken by mouth for a week or more. It is important to take these medications exactly for the full prescribed period.
• Anti-inflammatory medications: The doctor may prescribe medication to reduce inflammation in your child's body. This medication can also help reduce symptoms such as joint pain. If your symptoms are severe, the doctor may prescribe a stronger medication (corticosteroids).
• Other therapies: Because rheumatic fever affects each person differently, your doctor may recommend other treatments depending on how your child is affected. In severe cases, heart surgery or joint replacement may be necessary.

How can rheumatic fever be prevented?

This is the most important thing! Treating infections like strep throat and scarlet fever quickly and properly can help prevent rheumatic fever. The symptoms of strep throat and scarlet fever are not always obvious and easy to recognize. So, if your child has a sore throat for more than three days, or if you have other symptoms that you suspect, be sure to consult a doctor.

If your child's doctor tells you that he or she has strep throat or scarlet fever, follow his or her instructions exactly. Even if your child is feeling better, you should take the full course of antibiotics. Otherwise, the infection may not go away completely, and you may be more likely to develop rheumatic fever.

What else can you do to protect yourself from rheumatic fever?

Practicing good hygiene habits can help reduce your child's risk of getting bacterial infections. It can also help prevent the spread of infection from one child to another. Your child should always do these things:

• Wash your hands often (and thoroughly) with soap.
• When coughing or sneezing, cover your mouth with a tissue, elbow, or shoulder (not your hand).
• Discard the tissue used to sneeze or blow your nose once, and wash your hands.

If your child is diagnosed with rheumatic fever, your doctor may prescribe long-term antibiotics (such as monthly penicillin injections). This is called antibiotic prophylaxis . This can help prevent future strep throat and prevent rheumatic fever from recurring.

What is the outlook for someone with rheumatic fever?

Although there is no cure for rheumatic fever, the disease can be managed with treatment. By diagnosing the disease correctly and starting treatment as soon as symptoms appear, you can prevent permanent damage from the disease. Serious complications are less likely to occur. If they do, they can affect the child's heart, joints, nervous system, or skin.

Rheumatic fever can come back or become a serious problem. In some cases, rheumatic fever can cause complications that can be life-threatening. Therefore, regular medical checkups may be necessary to protect your child's long-term health.

Can rheumatic fever recur?

Yes. If your child gets strep throat or scarlet fever again, rheumatic fever can also come back. If your child has had rheumatic fever before, the doctor may recommend that your child take antibiotics for years, or even a lifetime. This treatment is called antibiotic prophylaxis . This can help prevent another strep infection and stop rheumatic fever from coming back.

What should I ask the child's doctor?

If your child has rheumatic fever, you can ask the doctor questions like these:

• What antibiotic do you recommend?
• How long should my child take this medicine?
• Will my child need to take antibiotics long-term?
• Will my child need other tests now or in the future?
• How can rheumatic fever affect my child now or in the future?
• Are there any activities that could be dangerous to my child's health?
• What kind of medical treatment will my child need going forward?
• What can I do to best protect my child's health?
• When should I call my child's doctor?

If you suspect your child has strep throat or scarlet fever, don't delay in calling your doctor. Early treatment can help prevent rheumatic fever. The characteristic symptoms of these bacterial infections are:

• Sore throat that lasts more than three days.
• Loss of appetite (especially due to difficulty swallowing).
• Swollen lymph nodes in the neck.
• Red spots that feel like sandpaper.
• Fever.
• Swollen, red, or spotted tonsils (glands at the back of the mouth).
• Headache.

Take-Home Message

Rheumatic fever is a rare complication of untreated strep throat or scarlet fever . It mostly affects children and young adults. In severe cases, it can cause serious health problems that affect a child's heart, joints, or other organs.

The most important thing is to see a doctor right away if you suspect your child has strep throat or scarlet fever. Doing so can help prevent rheumatic fever from developing. People with rheumatic fever often need lifelong medical advice and treatment to maintain their health. So, don't take your child's sore throat or fever lightly. Be concerned.

` Rheumatic fever, strep throat, scarlet fever, childhood diseases, heart disease, infections, immune system