ACUTE RHEUMATIC FEVER

Acute rheumatic fever (ARF) is a serious but preventable condition that primarily affects children and adolescents. It typically occurs as a result of an untreated or inadequately treated streptococcal throat infection, commonly known as strep throat. ARF can lead to long-term complications, including damage to the heart valves and an increased risk of developing rheumatic heart disease. In this article, we will delve into the causes, symptoms, and treatment options for acute rheumatic fever.

Causes

ARF is caused by an immune response to an untreated or poorly treated infection with Group A Streptococcus bacteria. When the body tries to fight off the bacteria, the immune system mistakenly attacks healthy tissues, particularly those in the joints, heart, skin, and brain. It's important to note that not everyone who has a strep throat infection will develop ARF, but the risk is higher in individuals who experience repeated strep infections or who have a family history of the disease.

Prevention

Preventing acute rheumatic fever begins with early and appropriate treatment of strep throat infections. If you or your child experience symptoms such as a sore throat, fever, and swollen glands, it is crucial to seek medical attention promptly. Taking the prescribed antibiotics as directed and completing the full course is essential to prevent the progression to ARF.

Complications If left untreated or inadequately managed, ARF can lead to long-term complications, the most significant of which is rheumatic heart disease (RHD). RHD occurs when the valves of the heart are damaged by the inflammatory response triggered by ARF. Over time, the damaged valves may become scarred, resulting in a condition known as valvular stenosis or regurgitation.

This can affect the heart's ability to pump blood efficiently, leading to symptoms such as fatigue, shortness of breath, and fluid retention. In severe cases, RHD can lead to heart failure, requiring lifelong management and potentially necessitating surgical intervention.

Diagnosis Diagnosing acute rheumatic fever involves a combination of clinical evaluation, medical history, and laboratory tests. The Jones criteria, which include major and minor criteria, are used to aid in the diagnosis. Major criteria include carditis (heart inflammation), polyarthritis (inflammation in multiple joints), chorea (Sydenham's chorea), subcutaneous nodules, and erythema marginatum. Minor criteria include fever, joint pain, elevated acute-phase reactants (such as C-reactive protein or erythrocyte sedimentation rate), and prolonged PR interval on an electrocardiogram.

A diagnosis of ARF requires evidence of preceding streptococcal infection (usually confirmed by a throat culture or rapid strep test) and the presence of either two major criteria or one major criterion plus two minor criteria.

Conclusion

In conclusion, acute rheumatic fever is a potentially serious condition that primarily affects children and adolescents. Early recognition, prompt treatment of strep throat infections, and adherence to antibiotic therapy are vital.