Rheumatic fever

Rheumatic fever

What is rheumatic fever?

Rheumatic fever (RF) is an antibody mediated disease which can involve the joints, heart, brain and skin. RF most often manifests with low grade fever, pain and swelling of large joints – polyarthritis (knee, ankle, elbow). Usually it occurs in children, but can occur in adults as well. The most important aspect of rheumatic fever is that it can involve the heart, mainly its valves, producing long term damage to the heart.

What causes rheumatic fever?

Rheumatic fever is due to cross reaction of antibodies produced by the body to against a bacterium known as streptococcus with the heart, joints and other connective tissue in the body. Hence it is an immunologically mediated disease. It usually occurs a few weeks after a sore throat caused by infection with streptococcus bacteria.

How can you prevent rheumatic fever?

RF can be prevented by promptly treating sore throat due to streptococcal infection with antibiotics, usually penicillin. Maintaining a good level of hygiene in the community is useful in preventing streptococcal sore throat. Overcrowding leads to epidemics of streptococcal sore throat.

What are the manifestations of rheumatic fever other than joint pains and heart disease?

RF can cause involuntary movements due to involvement of the brain known as ‘chorea‘. Manifestations in the skin can occur as small nodules under the skin (subcutaneous nodules) over bony prominence and reddish patches (erythema marginatum).