WHAT YOU SHOULD
KNOW
Rheumatic fever is a serious condition that sometimes
develops after a strep infection in the upper respiratory
tract. It's seen most frequently in young school-age children
who have not been treated with antibiotics. It typically
appears 2 to 6 weeks after the child recovers from the initial
infection---usually a sore throat or scarlet fever. If left
untreated, rheumatic fever may affect the brain, heart, joints,
and skin, and may prove fatal.
The problem usually occurs in the winter months and is
most common in areas where people lack adequate nutrition,
sanitation, and medical care.
Causes
This disease is caused by streptococcal bacteria that
invade the upper respiratory tract.
Signs/Symptoms
Rheumatic fever usually starts suddenly after 1 to 5
weeks with no symptoms. The earliest warnings include swelling,
heat, redness, tenderness, and pain in the joints, along with
problems moving two or more of the joints. These symptoms may
be accompanied by fever, nose bleeds, stomach pain, and
vomiting. In severe cases, the victim may develop carditis
(inflammation of the heart muscle), signaled by a pounding,
racing heart and chest pain.
Children with rheumatic fever tend to move awkwardly and
drop things. This condition, called chorea, may eventually lead
to jerky movements of the tongue and facial muscles that can
interfere with the child's ability to speak. Chorea usually
lasts 1 to 3 months.
The disease may also cause firm, painless bumps on the
child's joints, tendons, spine, elbows, knees, wrists, eyes,
and the back of the head.
A pink rash with a pale center and wavy borders is
another tell-tale sign. The rash usually appears on the trunk
and arms and legs and moves from place to
place.
Care
Children with rheumatic fever are usually given shots of
penicillin or erythromycin. If the heart is inflamed, the
doctor usually prescribes steroids to prevent permanent damage.
Hospitalization is usually not necessary.
If the child develops arthritis, your doctor may
prescribe aspirin; but this medicine is never used at the same
time as steroids. If the inflammation does not improve with
aspirin, the child may be given indomethacin (Indocin),
phenylbutazone, gold salts, or antima__lar__ia medications.
Acetaminophen (Tylenol) may help lower fever.
Exercise is important to maintain joint function as the
child recovers. Heat can help relieve joint pain. A healthy
diet helps speed recovery.
Risks
Without treatment the child may develop serious heart
problems such as murmurs, heart enlargement, and even heart
failure.
WHAT YOU SHOULD
DO
Call Your Doctor
If...
-
Your child develops
involuntary movements of the tongue or face (or begins to
have trouble speaking) 1 to 5 weeks after a strep throat or
other upper respiratory infection.
-
The child has sore joints or
hard, painless bumps on the joints.
-
A pink rash with a pale
center appears on the child's body.
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