Rheumatic Fever

Rheumatic fever is an inflammatory disease affecting the heart, joints, skin and central nervous system. It mostly occurs in children between the ages of 5 and 15 years and is caused by a bacteria called streptococci.

Rheumatic fever in Australia is not as common as it was in the pre-penicillin era. Quick antibiotic treatment of threatening ear, nose and throat infections has lessened the risk. Improvement in living standards and availability of medical attention have also helped.

Symptoms of rheumatic fever usually occur approximately 2 weeks after the initial throat, ear or nose infection. They include fever, widespread joint pain ad swelling, particularly of the arms and legs. Heart symptoms may be absent although signs of acute heart failure including breathlessness and general collapse can occur. A characteristic pink rash can appear on the trunk and upper parts of the arms and legs. Painless swellings of the bony prominences, mainly on the hands, feet and elbows may appear and chorea which consists of sudden aimless muscular movements associated with emotional instability may occur after joint symptoms have subsided. Chorea occurs often in females and may last for months.

Minor symptoms which may go unrecognised include recurrent attacks of fever, a general feeling of being unwell with weight loss in the growing child, generalised abdominal pain, recurring nose bleeds and what is often referred to as growing pains in the young child.

Specialised blood tests are needed to identify the disease. Complications of rheumatic fever involve the heart, leading to heart and valve disease in later life. It is important for your doctor to determine heart involvement as early as possible in the initial infection. Recurring streptococci infection increase the likelihood of heart complications.

The main form of treatment consists of preventative medicine. Streptococcal ear, nose and throat infections should be quickly indentified and treated with the appropriate use of antibiotics.

After rheumatic fever has occurred continuous antibiotic therapy may be necessary over a period of at least 5 years to prevent recurrences.

If there is evidence of heart involvement antibiotic treatment may have to be continued until the age of 25. It will be necessary to keep in regular touch with your doctor in order to have any heart complications evaluated as they appear and institute treatment when necessary.

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