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RHEUMATIC FEVER/RHEUMATIC HEART DISEASE

Rheumatic fever is an immune related disease initiated by streptococcal throat infection. Involvement of heart valves in rheumatic fever is rheumatic heart disease. Commonest age group is 5-15 year.

Symptoms

  • Chest pain
  • Joints pain (multiple, migratory and large joints)
  • Joints swelling
  • Fever
  • Red patches over trunk
  • Subcutaneous nodule
  • Jerky movements
  • Sore throat and fever about 10 days back

Causes

Immune related disease strongly associated with streptococcal throat infection. Antibodies directed against the streptococcal protein react with human connective tissue thus producing disease.

Diagnosis:

  • Clinical feature
  • ASO titer
  • ESR (Erythrocyte Sedimentation Rate)
  • WBC Count
  • ECG
  • Throat culture

Preventions

  • Primary: Identification of streptococcal infection of throat and treatment with penicillin to prevent Rheumatic fever.
  • Secondary: Once RF has occurred, long course of benzathine penicillin injection to prevent recurrence of disease and its progression to Rheumatic heart disease.

 

Complications

Rheumatic heart disease is the worrisome complication of Rheumatic fever. In RHD, heart valves are involved leading to subsequent complications.

Treatment

  • For RF:
    1. Penicillin
    2. Aspirin or Steroids
  • For RHD: Refer valvular heart disease