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Rheumatic Fever

Rheumatic Fever is a medical condition that can be seen as an inflammation response following a Strep infection of the throat.

Rheumatic fever is typically seen 2-3 weeks after a strep infection and in many cases, the individual may have had no symptoms of strep throat in the first place.

Strep infection can also be called a Beta-hemolytic streptococcal infection.

The problem can be when the Cardiac heart valve can become infected with bacteria and can occur as a result of Rheumatic fever. Other infections may affect organs such as Joints, the Brain, the skin, and others.

It is less common today but can still occur at any age, but is often seen between ages:  5 – 40. The most common ages are 5 – 15 years old.

Cases of Rheumatic fever are seen more often in developing countries.

Heart valves can be attacked

1.)  70% of the cases involve Mitral Valve

2.)  Aortic Valve

3.)  5% can be in Tricuspid or Pulmonary Valves

Symptoms and Diagnosis of Rheumatic Fever

This can be difficult and is referred to as The Jones Criteria

There are major and minor criteria under the Jones Criteria

Major Criteria

1.)  Carditis

–  Seen in children and young adults
–  Can be seen on EKG
–  Develops as congestive heart failure, pericarditis, or enlargement of the heart

2.)  Erythema marginatum

–  Rapidly enlarging rash
–  In the shape of rings
–  Has clear centers

2.)  Subcutaneous nodules

–  Rather uncommon
–  Small, firm, nodules that are nontender
–  Attached to bony areas
–  Can last for several days
–  Can be reoccurring

3.)  Sydenham’s Chorea

–  Abnormal movements of the face, tongue, and upper extremities
–  Can sometimes be the only symptom
–  Girls often show this symptom more often the boys
–  Adults rarely
–  Least common of the major but often the most helpful

4.)  Polyarthritis

–  The pain in joints (Osteoarthritis) moves or migrates
–  Adults often have only 1 joint affected
–  Can last 1-5 weeks

Minor Criteria of Rheumatic Fever

1.)  Fever
2.)  Change in PR interval
3.)  Polyarthralgias
4.)  Elevated Sedimentation rate
5.)  Elevated CRP rate

Treatment

.     Penicillin
.     Erythromycin
.     Sulfadazine
.     Salicylates for joint pain and fever
.     Prednisone