Rheumatic Fever

Rheumatic fever
Rheumatic fever is an inflammatory disease that may develop after an infection with group A Streptococcus bacteria (such as strep throat or scarlet fever). The disease can affect the heart, joints, skin, and brain.
Causes
Rheumatic fever is common worldwide and is responsible for many cases of damaged heart valves. It is not common in the United States, and usually occurs in isolated outbreaks. The latest outbreak was in the 1980s. Rheumatic fever mainly affects children ages 5 -15, and occurs approximately 14-28 days after strep throat or scarlet fever.
Symptoms

Abdominal pain Fever Heart (cardiac) problems, which may not have symptoms, or may result in shortness of breath and chest pain Joint pain, arthritis (mainly in the knees, elbows, ankles, and wrists) Joint swelling; redness or warmth Nosebleeds (epistaxis) Skin nodules Skin rash (erythema marginatum) o Skin eruption on the trunk and upper part of the arms or legs o Eruptions that look ring-shaped or snake-like Sydenham chorea (emotional instability, muscle weakness and quick, uncoordinated jerky movements that mainly affect the face, feet, and hands)
Exams and Tests

Your doctor or nurse will examine you. This will include carefully checking your heart sounds, skin, and joints. Tests may include:

Blood test for recurrent strep infection (such as an ASO test) Complete blood count Electrocardiogram Sedimentation rate (ESR)
Several major and minor criteria have been developed to help standardize rheumatic fever diagnosis. Meeting these criteria, as well as having evidence of a recent streptococcal infection, can help confirm that you have rheumatic fever.
The major criteria for diagnosis include:

Arthritis in several large joints (polyarthritis) Heart inflammation (carditis) Nodules under the skin (subcutaneous skin nodules) Rapid, jerky movements (chorea, Sydenham chorea) Skin rash (erythema marginatum)
The minor criteria include:

Fever High ESR Joint pain Abnormal EKG
You'll likely be diagnosed with rheumatic fever if you meet two major criteria, or one major and two minor criteria, and have signs that you've had a previous strep infection.
Treatment
If you are diagnosed with acute rheumatic fever you will be treated with antibiotics. Anti-inflammatory medications such as aspirin or corticosteroids reduce inflammation to help manage acute rheumatic fever. You may have to take low doses of antibiotics (such as penicillin, sulfadiazine, or erythromycin) over the long term to prevent strep throat from returning.
Outlook (Prognosis)
If rheumatic fever returns, your doctor may recommend you take low-dose antibiotics continually, especially during the first 3 -5 years after the first episode of the disease. Heart complications may be severe, particularly if the heart valves are involved.
Possible Complications

Arrhythmias Damage to heart valves (in particular, mitral stenosis and aortic stenosis) Endocarditis Heart failure Pericarditis Sydenham chorea
When to Contact a Medical Professional

Call your health care provider if you develop symptoms of rheumatic fever. Because several other conditions have similar symptoms, you will need careful medical evaluation.
If you have symptoms of strep throat, tell your health care provider. You will need to be evaluated and treated if you do have strep throat, to decrease your risk of developing rheumatic fever.
Prevention
The most important way to prevent rheumatic fever is by getting quick treatment for strep throat and scarlet fever.
Alternative Names
Acute rheumatic fever
References
Low DE. Nonpneumococcal streptococcal infections, rheumatic fever. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 298.
http://www.nlm.nih.gov/medlineplus/ency/article/003940.htm
1) Dekompensasi Cordis Peristiwa dekompensasi cordis pada bayi dan anak menggambarkan terdapatnya sindroma klinik akibat myocardium tidak mampu memenuhi keperluan metabolic termasuk pertumbuhan. Keadaan ini timbul karena kerja otot jantung yang berlebihan, biasanya karena kelainan struktur jantung, kelainan otot jantung sendiri seperti proses inflamasi atau gabungan kedua faktor tersebut. Pada umumnya payah jantung pada anak diobati secara klasik yaitu dengan digitalis dan obat-obat diuretika. Tujuan pengobatan ialah menghilangkan gejala (simptomatik) dan yang paling penting mengobati penyakit primer. 2) Pericarditis Peradangan pada pericard visceralis dan parietalis yang bervariasi dari reaksi radang yang ringan sampai tertimbunnnya cairan dalam cavum pericard.

Rheumatic Fever

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Rheumatic Fever

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Rheumatic fever

Exams and Tests

The major criteria for diagnosis include:

The minor criteria include:

Fever High ESR Joint pain Abnormal EKG

When to Contact a Medical Professional

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