Rheumatic Fever
In this condition factsheet:
Diagnosing Rheumatic Fever
The actual quantity of bacteria in the systems of people with rheumatic fever is often so low that the bacteria are undetectable. Doctors rely on a standardized checklist to identify the disease.
If you have a recent history of streptococcal infection, and at least 2 symptoms from a list of 5 common symptoms: arthritis, chorea, erythema marginatum, nodules under the skin, and carditis, your doctor may diagnose you with rheumatic fever.
Your doctor will listen to your heart with a stethoscope to help detect carditis. The diagnosis can also be made with only one of these common symptoms if other abnormalities are present at the same time. These include: sore joints, fever, rheumatic fever in the past, a specific abnormality on electrocardiogram (ECG; prolonged PR interval), or specific abnormalities on blood testing (elevated C-reactive protein or sedimentation rate).
Certain tests can also support the diagnosis by detecting antibodies the body produce against the Streptococcus bacteria, or by detecting the bacteria itself.
Before making any treatment decisions, your doctor will want to rule out other conditions that can affect the heart. Tests like the echocardiogram (ultrasound of the heart) can reveal the presence of congenital heart defects that might be confused with rheumatic fever.
Treating and Preventing Rheumatic Fever
The best way to prevent rheumatic fever is to have strep throat treated promptly with penicillin* or other antibiotics. The strep infection should be confirmed with a throat swab before treatment is started, and rheumatic fever will be prevented as long as treatment is started within 5 or 6 days. Therefore, there is time to safely wait for the swab result. The main reason to treat strep throat is to prevent rheumatic fever. Pain killers, hot drinks, and gargling would also help the sore throat, but only the antibiotics can kill the bacteria and make the symptoms disappear.
Although bacteria are responsible for triggering rheumatic fever, antibiotics can do little to help once you have rheumatic fever, and treatment then aims at relieving symptoms. The normal treatment for joint inflammation and pain in rheumatic fever is the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Because people who've had rheumatic fever are more prone to further attacks if they get another strep infection, they may be given monthly intramuscular penicillin or daily penicillin treatment by mouth, perhaps for life. If their heart has been damaged by rheumatic fever, they're also given a different antibiotic when they undergo any dental or surgical procedures to reduce the risk of bacterial heart valve infection (endocarditis).
There's no treatment that will make chorea go away more quickly, though children with chorea are often given antibiotics to prevent endocarditis. Fortunately, the symptoms of chorea often disappear within a few months, although sometimes they may take a year or more to go away.
The rash and the nodules usually clear up on their own.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Rheumatic-Fever
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