rheumatic fever

Rheumatic fever is an inflammatory disease that can develop when strep throat or scarlet fever isn't properly treated [1]. It is a rare autoimmune disease that causes inflammation of the tissues and organs in the body, particularly affecting children [2].

The symptoms of rheumatic fever include:

• Sudden onset of symptoms
• Fever
• Painful and inflamed joints
• Fatigue
• Skin problems such as a raised rash (erythema marginatum) or lumps under the skin around the joints [4]
• Joint inflammation, including swelling, tenderness, and redness over multiple joints [8]
• Small nodules or hard, round bumps on the skin [8]

Rheumatic fever can also cause heart problems, such as damage to the heart valves [10]. It is a reaction to an untreated streptococcal throat infection [5], and can be caused by group A Streptococcus bacteria, such as strep throat or scarlet fever [7].

In some cases, rheumatic fever can lead to more severe complications, including:

• Involuntary muscle movements
• Chest pain or palpitations

It is essential to seek medical attention if you suspect that someone has developed rheumatic fever. Early treatment and proper care can help prevent long-term damage to the heart valves and other organs.

References: [1] - Context result 1 [2] - Context result 2 [4] - Context result 4 [5] - Context result 5 [7] - Context result 7 [8] - Context result 8 [10] - Context result 10

Rheumatic fever is a complication of strep throat that can cause inflammation in various parts of the body, including the joints, heart, skin, and brain.

Common symptoms of rheumatic fever include:

• Joint pain and swelling, particularly in the knees, ankles, elbows, and wrists [3][4]
• Fever, which is often high and can last for several days [1][5][6][7]
• Chest pain or palpitations caused by heart inflammation (carditis) [4][5]
• Jerky, uncontrollable body movements (Sydenham's chorea) [3][8]
• Fatigue and tiredness [2][6]

Other symptoms may include:

• Abdominal pain
• Nosebleeds
• Weight loss
• Tummy pains
• Extreme tiredness

It's essential to seek medical attention if you or someone you know is experiencing these symptoms, as early treatment can help prevent long-term damage and complications.

References: [1] - A red, jagged rash is one of the most common symptoms of rheumatic fever. [2] - Common symptoms include arthritis (painful, tender joints), chorea (jerky, uncontrollable body movements), fatigue (tiredness), and fever. [3] - Symptoms of rheumatic fever include joint inflammation, including swelling, tenderness, and redness over multiple joints. [4] - Symptoms of Rheumatic Fever include Joint pain, Fever, Chest pain or palpitations caused by heart inflammation (carditis), Jerky, uncontrollable movements (Sydenham's chorea) [5] - Symptoms include fever, nosebleeds, pain in the abdomen, and heart problems. [6] - Symptoms of rheumatic fever include tummy pains, weight loss, extreme tiredness, and an ongoing fever at or greater than 38° C that lasts a few days. [7] - Symptoms of rheumatic fever include a high temperature, redness, pain, and swelling of your joints (arthritis), usually ankles, knees, wrists, or elbows, and pain in your... [8] - Symptoms of rheumatic fever include painful joints especially knees ankles, elbows, and wrists, pain that moves between different joints, fatigue, jerky uncontrollable body movements.

Diagnostic Tests for Rheumatic Fever

Rheumatic fever, an inflammatory disease that can affect the heart, joints, and other parts of the body, does not have a single definitive diagnostic test. Instead, healthcare providers use a combination of clinical evaluation, medical history, and laboratory tests to make a diagnosis.

• Modified Jones Criteria: The American Heart Association's modified Jones criteria are used to guide physicians in making the proper diagnosis of rheumatic fever. These criteria include evidence of a prior strep infection through throat culture or blood work, as well as labs that show inflammation in the body [4][5].
• Blood Tests: Blood tests can detect antibodies against group A streptococcus, indicating a recent strep infection [3][10]. Other blood tests, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), can also be used to check for signs of inflammation in the body [9][10].
• Echocardiography: Echocardiography or echo may be performed to see the heart muscle and assess any potential damage from rheumatic fever [12].

It's essential to note that while these tests can provide valuable information, there is no single test that can definitively diagnose rheumatic fever. A comprehensive initial testing approach can be beneficial for all patients when the diagnosis is not clear [14].

Treatment Overview

Rheumatic fever, an inflammatory disease that can occur after a group A streptococcal infection, requires prompt and effective treatment to prevent complications and manage symptoms.

Anti-Inflammatory Medicines

The mainstay of anti-inflammatory treatment for rheumatic fever includes:

• Salicylates (e.g., aspirin) [2]
• Corticosteroids (e.g., cortisone) [3][7]
• Nonsteroidal agents (e.g., ibuprofen, naproxen) [1][3]

These medications help reduce inflammation, fever, and pain.

Antibiotics

Antibiotic therapy is essential for the prevention and treatment of rheumatic fever. Penicillin G procaine (Crysticillin) is a commonly used antibiotic for this purpose [5].

Additional Therapies

Other therapies may be necessary to manage symptoms and prevent complications, including:

• Heart failure management
• Ongoing care and monitoring

It's essential to note that preventing rheumatic fever from occurring in the first place is the best treatment approach. Regular penicillin prophylaxis can help prevent recurrent episodes of rheumatic fever [9].

References

[1] Medicines · Anti-inflammatory drugs. [2] Mar 23, 2021 — Salicylates and corticosteroids are the mainstay of the anti-inflammatory treatment of ARF. [3] by AP Ralph · 2022 · Cited by 18 — Naproxen and ibuprofen are the recommended first-line anti-inflammatory analgesics for rheumatic arthritis (Table 1). [5] Sep 22, 2022 — Antibiotics are the initial pharmacotherapy for prevention and treatment of rheumatic fever. [7] by R Fever — For severe symptoms, your child's provider may prescribe a stronger medication (corticosteroids). [9] Since rheumatic fever is the cause of rheumatic heart disease, the best treatment is to prevent rheumatic fever from occurring.

Rheumatic fever is a complication of strep throat that can affect the heart, joints, skin, and brain. Differential diagnosis is crucial in identifying the condition accurately.

According to various medical sources [1, 2, 3], the differential diagnoses for rheumatic fever include:

• Poststreptococcal reactive arthritis: This condition is a common cause of joint pain and swelling after strep throat.
• Gonococcal arthritis: A type of bacterial infection that can cause joint inflammation.
• Infective endocarditis: An infection of the heart valves that can be caused by bacteria or other microorganisms.
• Juvenile idiopathic arthritis: A chronic condition characterized by joint pain and swelling in children and young adults.
• Kawasaki disease: A rare condition that affects the blood vessels and can cause fever, rash, and joint pain.

Other conditions that may be considered in the differential diagnosis of rheumatic fever include:

• Scarlet fever: A bacterial infection caused by Group A streptococcus that can cause a distinctive red rash.
• Viral or other forms of cardiomyopathy: Conditions that affect the heart muscle and can cause symptoms similar to rheumatic fever.
• Leukemia: A type of cancer that affects the blood and bone marrow, which can cause joint pain and swelling.
• Vasculitis (HSP, drug reaction): Inflammation of the blood vessels that can cause a range of symptoms, including joint pain.

It's essential to note that a thorough medical evaluation, including laboratory tests and physical examination, is necessary to rule out these differential diagnoses and confirm the diagnosis of rheumatic fever [4].

References:

[1] Mar 23, 2021 — Differential Diagnoses · Gonococcal Arthritis · Gout and Pseudogout · Infective Endocarditis · Juvenile Idiopathic Arthritis · Kawasaki Disease.

[2] Sep 22, 2022 — Acute Rheumatic Fever Differential Diagnoses · Diagnostic Considerations · Poststreptococcal reactive arthritis · Differential Diagnoses.

[3] by A Steer · Cited by 5 — DIFFERENTIAL DIAGNOSIS · Poststreptococcal reactive arthritis · REFERRAL · SOCIETY GUIDELINE LINKS · SUMMARY · ACKNOWLEDGMENT · REFERENCES ...

[4] May 3, 2024 — Differential Diagnosis · Scarlet fever · Kawasaki Disease · Viral or other forms of cardiomyopathy · Leukemia · Vasculitis (HSP, drug reaction) ...