Rheumatic fever can be a serious disease as it can
involve the heart and can lead to chronic heart disease if not
detected and treated in time.
SYMPTOMS: The disease follows a sore throat with painful and tender lymph nodes under
the jaws. This sore throat
is caused by a specific bacterium. It should be
distinguished from a sore throat due to a viral infection in which the
patient also has cough and a runny nose without enlargement of
the neck glands.
In a typical case, a child of school going age (5 to 15 years) has a sore throat as mentioned
above. One to 3 weeks later, he presents with flitting joint pain and
swelling. It usually affects the big joints. By flitting
pain, we mean that the joint involved becomes normal in a day or
two while another gets affected. Then the second becomes completely normal while a third is
found to be painful
and swollen. Besides this typical problem with the joints,
the patient also has fever. He may get a rash on the trunk
which comes and goes. He gets nodular swellings on the back of the head or on the elbows and legs and the doctor may
find that his heart is affected. Some cases present with
abnormal involuntary movements of the body and limbs (chorea).
Your doctor may find some other features.
TREATMENT: The doctor may ask for some blood tests. He may also order an ECG
(electrocardiogram) and a chest X-ray. In a chronic case with involvement of the heart,
an echocardiogram may be needed.
Bed rest, treatment for a sore throat, and aspirin is
the commonly prescribed regimen. Let your doctor decide how long your child should stay at home. The more important
point that you must remember is that further attacks of bacterial sore throat in children who have had
fever must be prevented. For that, the doctor will ask you to
give the child a medicine to be taken regularly for a number
of years. This is essential because further attacks can
adversely affect the heart.
In case of a tooth extraction, or surgery inside the
mouth, the doctors will also put the child on a medicine just
before and for some time after it. You must therefore tell the surgeon that
the child has had rheumatic fever in the
past, so that he can take the necessary precautions.
11 February, 2013