Acute rheumatic fever
| Rheumatic fever | |
|---|---|
| Synonyms | Acute rheumatic fever (ARF) |
| bacteria (Pappenheim's stain) the trigger for rheumatic fever. | |
| Specialty | Cardiology |
| Symptoms | Fever, multiple painful joints, involuntary muscle movements, erythema marginatum |
| Complications | Rheumatic heart disease, heart failure, atrial fibrillation, infection of the valves |
| Usual onset | 2–4 weeks after a , age 5-14 years |
| Causes | Autoimmune disease triggered by |
| Risk factors | Genetics, malnutrition, poverty |
| Diagnostic method | Based on symptoms and infection history |
| Prevention | Antibiotics for strep throat, improved sanitation |
| Treatment | Prolonged periods of antibiotics, valve replacement surgery, valve repair |
| Frequency | 325,000 children a year |
| Deaths | 319,400 (2015) |
| Classification | |
|---|---|
| External resources |
Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a . Signs and symptoms include fever, multiple painful joints, involuntary muscle movements, and occasionally a characteristic non-itchy rash known as erythema marginatum. The heart is involved in about half of cases. Damage to the heart valves, known as rheumatic heart disease (RHD), usually occurs after repeated attacks but can sometimes occur after one. The damaged valves may result in heart failure, atrial fibrillation and infection of the valves.
Rheumatic fever may occur following an infection of the throat by the bacterium . If the infection is untreated rheumatic fever can occur in up to three percent of people. The underlying mechanism is believed to involve the production of antibodies against a person's own tissues. Due to their genetics, some people are more likely to get the disease when exposed to the bacteria than others. Other risk factors include malnutrition and poverty. Diagnosis of RF is often based on the presence of signs and symptoms in combination with evidence of a recent streptococcal infection.
Treating people who have strep throat with antibiotics, such as penicillin, decreases the risk of developing rheumatic fever. In order to avoid antibiotic misuse this often involves testing people with sore throats for the infection, which may not be available in the developing world. Other preventive measures include improved sanitation. In those with rheumatic fever and rheumatic heart disease, prolonged periods of antibiotics are sometimes recommended. Gradual return to normal activities may occur following an attack. Once RHD develops, treatment is more difficult. Occasionally valve replacement surgery or valve repair is required. Otherwise complications are treated as per normal.
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