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What Is Rheumatic Fever?

Rheumatic fever is an uncommon inflammation of the heart, nervous system, skin, and joints after a recent bacterial infection. Rheumatic fever usually occurs in children younger than 18. Rheumatic fever cannot be caught, but the infection that causes it can.

What Causes Rheumatic Fever?

Rheumatic fever is an autoimmune disorder, which means that the body reacts against its own cells or tissues. A recent strep throat infection triggers it. The infection with the bacteria named Streptococcus may have been mild or untreated. Substances called antibodies produced during the infection also attack and can destroy cells in the joints, the heart, and other body parts.

What Are the Symptoms of Rheumatic Fever?

Symptoms include fever, loss of appetite, mild rash, tiredness, paleness, small bumps under the skin over bony areas (such as hands, wrists, elbows, and knuckles), and joint inflammation with pain, swelling, and warmth.

If the heart is affected, shortness of breath, swelling of the ankles and around the eyes, and rapid heartbeat may occur. If the brain is affected, uncontrolled jerky movements may occur.

The most common complication is damage to heart valves that causes a heart murmur. Sometimes the damaged valves may need to be replaced.

How Is Rheumatic Fever Diagnosed?

The health care provider will suspect a diagnosis from the medical history, physical examination, and laboratory tests. A chest x-ray, electrocardiography (ECG), and throat culture will be done. The health care provider will order another test called echocardiography to look for heart valve damage.

If heart damage is present, you will be referred to a cardiologist (a doctor who specializes in heart diseases).

How Is Rheumatic Fever Treated?

Children must limit their activity until symptoms are gone, which could take 2 to 5 weeks.

Antibiotics for the bacteria will be given for several days. Tell your health care provider if your child is allergic to penicillin.

In the early stages a liquid or soft diet may be better. Later a normal diet that is high in calories, protein, and vitamins is followed.

Aspirin or other antiinflammatory drugs are given for muscle and joint pain.

DOs and DON’Ts in Managing Rheumatic Fever:

  • DO have your child take antibiotics until the prescription is all gone.
  • DO have your child with a fever drink enough fluids.
  • DO have your child rest and then start activity gradually. Rest periods and naps should be scheduled.
  • DO get prompt evaluation for future sore throats.
  • DO tell doctors and dentists about your child’s rheumatic fever.
  • DO call your health care provider if during treatment your child has swollen legs or ankles, shortness of breath, vomiting, diarrhea, dry hacking cough, severe pain in the abdomen (belly), or a temperature of 101°F or higher.
  • DON’T let your child resume activity until the fever and other symptoms are gone.

Contact the following sources:

  • National Heart, Lung, and Blood Institute Information Center
    Tel: (301) 592-8573
  • American Heart Association
    Tel: (800) 242-8721

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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