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Rheumatic Fever
Rheumatic fever is a complication that occurs as the result of either untreated strep throat or scarlet fever. Since the advent of antibiotics used to treat bacterial throat infections, the incidence of rheumatic fever and rheumatic heart disease has declined sharply. In rheumatic fever, there is damage to the heart valves which can lead to the development of valvular dysfunction, known as aortic stenosis. Damage may also occur to the mitral valve resulting in mitral regurgitation. This damage occurs through a complex process involving the body's abnormal immunologic response to
the bacteria. A similar process can occur in the kidneys, leading to specific kidney damage known as acute glomerulonephritis. Common symptoms include multiple joint PAINS with joint SWELLING (knees andankles are common). Fever and recent sore throat are commonly seen in cases of rheumatic fever. A generalized red rash may be seen in some cases. Evaluation includes taking a throat culture if a streptococcal throat infection is suspected. Special serologic blood tests (ASO titers and ASTZ) can also aid in making the diagnosis. Echocardiogram is useful in showing any heart valve (aortic valve) damage and improper heart function. Treatment is with high dose antibiotics (frequently administered IV). The key to the eradication of rheumatic fever is in early detection and treatment of all bacterial throat infections before damaging complications can develop. Seriously damaged heart valves may require replacement with an artificial valve. Patients with known rheumatic heart disease require preventative antibiotics prior to dental procedures and some medical diagnostic tests. See your physician for assistance with this problem. An Internist or Cardiologist are the experts in the treatment of this problem.
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