Rheumatic fever is an autoimmune disease that inflames the body’s tissues, such as the joints and heart. It happens when the body’s immune system overreacts to a strep throat or scarlet fever infection that hasn’t been fully treated.Rheumatic fever is an autoimmune disease that inflames the body’s tissues, such as the joints and heart. It happens when the body’s immune system overreacts to a strep throat or scarlet fever infection that hasn’t been fully treated. It causes your body’s immune system to attack its own tissues, causing inflammation (swelling). Rheumatic fever may affect the joints, heart or blood vessels.
Rheumatic fever is one of the complications associated with strep throat. It’s a relatively serious illness that usually appears in children between the ages of 5 and 15.
Rheumatic fever is not contagious. You can’t give it to or get it from someone else. But strep throat and scarlet fever are contagious. These infections spread through respiratory droplets.
A wide variety of symptoms are associated with rheumatic fever. A person with the illness could experience a few, some, or most of the following symptoms. Symptoms usually appear two to four weeks after your child has a strep infection.
Common symptoms of rheumatic fever include:
• small, painless nodules under the skin
• a flat, slightly raised, ragged rash
• chest pain
• shortness of breath
• high fever
• rapid fluttering or pounding chest palpitations
• painful or sore joints in the wrists, elbows, knees, and ankles
• pain in one joint that moves to another joint
• red, hot, swollen joints
• jerky, uncontrollable movements of the hands, feet, and face
• stomach pain
• a decrease in attention span
• outbursts of crying or inappropriate laughter
• lethargy or fatigue
Rheumatic fever can occur after a throat infection from a bacteria called group A streptococcus. Group A streptococcus infections of the throat cause strep throat or, less commonly, scarlet fever.
The link between strep infection and rheumatic fever isn’t clear, but it appears that the bacteria trick the immune system.
The strep bacteria contain a protein similar to one found in certain tissues of the body. The body’s immune system, which normally targets infection-causing bacteria, attacks its own tissue, particularly tissues of the heart, joints, skin and central nervous system. This immune system reaction results in swelling of the tissues (inflammation).
If your child has one or more episodes of strep throat or scarlet fever that aren’t treated or aren’t treated completely, he or she might develop rheumatic fever.
Risk Factors –
Certain factors can increase your risk of getting rheumatic fever:
• Where you live
Most people with rheumatic fever live in places that have limited medical resources, such as resource-poor countries. Living in an area where it’s difficult to get medication or medical care may also put you at risk.
• Type of strep bacteria present
Certain strains are more likely than others to lead to rheumatic fever.
Rheumatic fever mostly affects children or teenagers between 5 and 15.
• Overall health
Having a weakened immune system can increase your risk. Children who frequently get strep infections may be more likely to get rheumatic fever.
• Family history
If someone in your family has had rheumatic fever, other family members may be more likely to get it.
• Crowded areas
Bacteria spread more easily in places where large groups gather.
One of the most prevalent complications is rheumatic heart disease. Other heart conditions include:
• Aortic valve stenosis. This is a narrowing of the aortic valve in the heart.
• Aortic regurgitation. This is a leak in the aortic valve that causes blood to flow in the wrong direction.
• Heart muscle damage. This is inflammation that can weaken the heart muscle and decrease the heart’s ability to pump blood effectively.
• Atrial fibrillation. This is an irregular heartbeat in the upper chambers of the heart.
• Heart failure. This occurs when the heart can no longer pump blood to all parts of the body.
If left untreated, rheumatic fever can lead to:
• permanent damage to your heart
Your child’s doctor will first want to get a list of your child’s symptoms and their medical history. They’ll also want to know if your child has had a recent bout of strep throat. Next, a physical exam will be given. Your child’s doctor will do the following, among other things:
• Look for a rash or skin nodules.
• Listen to their heart to check for abnormalities.
• Perform movement tests to determine their nervous system dysfunction.
• Examine their joints for inflammation.
• Test their throat and sometimes blood for evidence of strep bacteria.
• Perform an electrocardiogram (ECG or EKG), which measures the electric waves of their heart.
• Perform an echocardiogram, which uses sound waves to produce images of their heart.
Treatment aims to destroy the bacteria, relieve symptoms, control inflammation, and prevent recurrences of rheumatic fever.
Antibiotics, such as penicillin, may be given to destroy any remaining strep bacteria in the body. Further antibiotics may be prescribed, to prevent recurrence. This may continue for 5-10 yearsTrusted Source depending on the age of the person and whether or not the heart is affected.
Long-term, and even lifelong, preventive antibiotics may be necessary to prevent recurring inflammation of the heart.
It is important to remove all traces of streptococcal bacteria, as any remaining bacteria can lead to repeated occurrences of RF and a significantly higher risk of heart damage, which can become permanent.
Anti-inflammatory drugs: Naproxen, for example, may help to reduce pain, inflammation, and fever.
Corticosteroids: Prednisone may be given if the patient does not respond to first-line anti-inflammatory medications, or if there is inflammation of the heart.
Aspirin: This is not usually recommended for children aged under 16 years because of the risk of developing Reye’s syndrome, which can cause liver and brain damage, and even death, but an exception is usually made in cases of RA because the benefits are greater than the risks.
Anticonvulsant medications: These can treat severe chorea symptoms. Examples include valproic acid (Depakene or Stavzor), carbamazepine (Carbatrol or Equetro), haloperidol (Haldol) and risperidone (Risperdal).
Anyone who has rheumatic fever as a child will need to inform their doctor as they get older because heart damage can appear many years later.
Ayurvedic Perspective –
According to Ayurveda, Rheumatic fever is classified as Amavata jwara. The word Ama refers to undigested matter that forms toxins. When people with a sedentary lifestyle coupled with low digestion/metabolism, indulge in incompatible diet, or physical exertion after taking fatty food, the ama (toxic matter) is formed. This ama is fueled by unbalanced vayu & reaches the site of kapha. The amrasa (Ras dhatu – tissues- contaminated with ama) on being completely processed & highly vitiated by vata,pitta and kapha, circulate the body through the vessels and causes symptoms such as aches, fever etc, of amavata jwara.
▪︎ Line of treatment –
Treating it with Ayurvedic medicines includes :
a) Initially clean the toxins out of the colon by using Triphala plus or Avipattikar.
b) Next enhance the digestive fire by using amla, peppermint formula, Ginger etc.
c) Treat the fever by taking Boswellia, turmeric formulas, kaishor guggul, guduchi, musta, saffron etc.
d) Then massage with Brahmi oil or mahanarayana oil to calm the vata doshas.
e) Then administer enemas in order to clear vata by using castor oil or seasame oil.
▪︎ Ayurvedic medications –
• Rasnapanchakam Kashaayam
• Rasnasapthakam Kasahayam
• Shaddharanam Choornam
• Sudarsanam Gulika
• Amavatari Vati
• Yogaraja Guggulu
• Singhnad Guggulu
• Panchakola Choornam
The most effective way to make sure your child doesn’t develop rheumatic fever is to start treating their strep throat infection within several days and to treat it thoroughly. This means ensuring your child completes all prescribed doses of medication.
Practicing proper hygiene methods can help prevent strep throat:
• Cover your mouth when coughing or sneezing.
• Wash your hands.
• Avoid contact with people who are sick.
• Avoid sharing personal items with people who are sick.
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