RHEUMATIC FEVER

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 rheumatic 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