Rheumatic Fever: Causes, Symptoms (Rash) & Treatment

Overview

What is Rheumatic Fever?

Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever, which are caused by bacteria called group A Streptococcus. This condition can affect the heart, joints, skin, and brain.

Scarlet Fever vs. Rheumatic Fever

Although both caused by Streptococcus bacteria, scarlet fever and rheumatic fever are distinct. Scarlet fever results directly from infection, while rheumatic fever follows as a delayed, immune-mediated response to an untreated or improperly treated infection.

How Common is Rheumatic Fever?

Rheumatic fever was once a common and serious childhood disease in the United States but has become much less common due to improved diagnosis and treatment of strep throat.

Symptoms and Causes

What are the Symptoms of Rheumatic Fever?

Signs of rheumatic fever include fever, joint inflammation and pain, a specific type of rash known as erythema marginatum, and involuntary muscle movements. Heart involvement, which may become evident through new or changed heart murmurs, is a significant concern.

What Causes Rheumatic Fever?

The primary cause of rheumatic fever is an untreated or inadequately treated infection with group A Streptococcus bacteria, which is responsible for conditions like strep throat and scarlet fever.

Who Gets Rheumatic Fever?

Rheumatic fever can occur at any age but typically affects children between 5 and 15 years old. Adults are less commonly affected.

How Often does Strep Throat or Scarlet Fever Cause Rheumatic Fever?

Not every case of strep throat or scarlet fever will lead to rheumatic fever. The risk increases if these infections are improperly treated or not treated at all.

Who’s at Risk for Rheumatic Fever?

Certain factors, including genetic predisposition and environmental aspects, can increase the risk of developing rheumatic fever after a group A Streptococcus infection.

Can Adults Get Rheumatic Fever?

Yes, although it is rare, adults can develop rheumatic fever, especially if they have underlying health conditions that compromise their immune system.

Is Rheumatic Fever Contagious?

Rheumatic fever itself is not contagious, but the strep infections that can lead to rheumatic fever are transmissible.

How does Rheumatic Fever Affect the Heart?

Rheumatic fever can lead to rheumatic heart disease, characterized by damage to heart valves, which may manifest as heart murmur or even heart failure in severe cases.

Can Rheumatic Fever Cause Rheumatoid Arthritis?

Despite similar names, rheumatic fever and rheumatoid arthritis are different diseases. Rheumatic fever may cause joint symptoms but does not directly lead to rheumatoid arthritis.

Diagnosis and Tests

How is Rheumatic Fever Diagnosed?

Diagnosing rheumatic fever involves a combination of clinical evaluation, which considers signs and symptoms, and laboratory tests to identify preceding strep infection.

What Other Tests Will be Done to Diagnose Rheumatic Fever?

Additional tests may include blood tests for inflammation and evidence of recent strep infection, EKGs to assess heart function, and imaging to evaluate heart valve damage.

What are the Jones Criteria for Rheumatic Fever?

The Jones criteria is a guideline used to diagnose rheumatic fever. It includes major and minor criteria focusing on signs of inflammation, joint symptoms, heart involvement, and evidence of a recent strep infection.

Management and Treatment

How is Rheumatic Fever Treated?

Treatment for rheumatic fever includes antibiotics to eradicate the Streptococcus bacteria, anti-inflammatory medications to reduce inflammation and manage symptoms, and sometimes medications to control involuntary movements. Long-term prophylaxis with antibiotics may be recommended to prevent recurrence.

Long-term Management of Rheumatic Fever

Patient management over the long term may include regular follow-ups with a healthcare provider to monitor the disease’s impact on heart health and adjust treatments as necessary. Lifestyle adjustments and adherence to preventative measures play crucial roles in managing rheumatic fever and preventing recurrence.

Prevention

How Can I Prevent Rheumatic Fever?

Preventing rheumatic fever involves promptly treating strep throat or scarlet fever with appropriate antibiotics to prevent the disease from progressing.

What Else Can I Do to Protect Against Rheumatic Fever?

Maintaining good hygiene practices, such as frequent handwashing, can help prevent the spread of infections that could lead to rheumatic fever.

Impact on Daily Life and Coping Strategies

Adjustments in Daily Life

Living with rheumatic fever may require adjustments in daily activities to manage symptoms and prevent flare-ups. This may include dietary changes, regular exercise, and avoiding factors that could trigger symptoms.

Coping Strategies for Patients and Families

Coping with a diagnosis of rheumatic fever can be challenging for both patients and their families. Support groups, counseling, and education about the disease can provide valuable tools for managing the condition emotionally and physically.

Outlook / Prognosis

What’s the Outlook for Someone with Rheumatic Fever?

With proper treatment, the outlook for most individuals with rheumatic fever is good. However, complications like rheumatic heart disease can have long-lasting impacts.

Living With

Can Rheumatic Fever Come Back?

Yes, individuals who have had rheumatic fever are at an increased risk of recurrent episodes, especially if they are exposed to additional group A Streptococcus infections. Long-term antibiotic prophylaxis is often recommended to reduce this risk.

What Should I Ask My Child’s Healthcare Provider?

Key questions might include inquiry about the severity of the disease, implications for heart health, recommended treatment and monitoring plans, and strategies for preventing recurrence.