Rheumatic fever


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Rheumatic fever, also referred to as acute rheumatic fever (ARF), is an inflammatory disease associated with autoimmune diseases family. It usually develops within a month after a step throat, and it is caused by group A streptococcus bacteria. In most cases this disease affects children between the age of 5 and 14 years, resulting in numerous deaths worldwide. It is a systemic disease, which frequently attacks multiple organs or tissues simultaneously, such as heart, skin, nervous system or joints. Rheumatic fever common signs include fever, joint inflammation, rash and chorea.

Rheumatic fever characteristics

ARF is caused by group A streptococcus (GAS) bacteria, which leads to an abnormal response of the immune system, thus leading to several dangerous symptoms included in Jones criteria. tabletki4Statistically, this condition occurs in 2 to 4 weeks after streptococcal pharyngitis, which is commonly known as a step throat. It is a systemic disease, which means it can attack multiple organs or tissues simultaneously. Although it may affect adults, children between the age of 5 and 14 are the main victims of the rheumatic fever. Without medical intervention, it can lead to permanent damage, or even death. What is more, accurate diagnosis may be hard to establish, therefore Jones Criteria is used in order to help identifying rheumatic fever. The disease is prevalent globally, but it is most common in the developing countries.

Rheumatic fever symptoms

There are several symptoms associated with ARF, and not all of them may be present at the same time. Bearing in mind close relation to a step throat, exactly this preceded disease should be taken as a warning sign.

Rheumatic fever common symptoms include:

  • Fever
  • Chest pain
  • Shortness of breath
  • Chorea
  • Pain and inflammation of the joints
  • Rash

According to the above, one of the most popular symptom is carditis, which can potentially cause permanent heart damage or even death. Chest pain and shortness of breath are the signs related to carditis. probka_badania2This type of inflammation occurs in over half of the cases, but it is  difficult to identify for the patient. Fever occurs in early stage of the disease, ranging from 38.2 to 38.9 °C. Chorea, which is an abnormal involuntary disorder, appears in 20 to 30% of the cases, and may show up in very late stages. Joints pain or inflammation is a result of polyarthritis and involves 5 or more big joints at the same time. Usually it progresses to the top of the body, starting from the bottom.

Rheumatic fever diagnosis and Jones Criteria

Rheumatic fever was precisely described by T. Duckett Jones in 1944. Rheumatic feverHis criteria have been successfully revised by the American Heart Association and other minor groups, in order to help the doctors in proper diagnosis. ARF can be confirmed if the patient had step throat in the recent past, and currently manifests two of the major criteria, or one major criteria along with two minor criteria.

Jones criteria listed below:

Major criteria

Minor Criteria

Polyarthritis

Fever (38.2-38.9 °C / 100.8-102.0 °F)

Carditis

Arthralgia

Subcutaneous nodules

High Erythrocyte sedimentation rate or C reactive protein

Erythema marginatum

Leukocytosis

Sydenham’s chorea (St. Vitus dance)

ECG changes

 

Rheumatic fever treatment

At the beginning AFR treatment involve penicillin delivery, which eliminate bacteria responsible for infection, in order to restore proper functioning of the immune system. Aspirin and corticosteroids are given to achieve inflammation relieve in affected areas. The worst case scenario of rheumatic fever consequence is carditis, which require penicillin injections every month, and the cycle can last up to 40 years.

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