Sunday, 10 February 2008

Rheumatic Fever and Joint Pain

Multiple joint pain and swelling in a child can indoicate Rheumatic Fever.

Rheumatic fever affects joints, brain and heart. The joints and brain usually recover completely without any residual problem but damage to the heart can be permanent. It affects the heart valves preventing them from functioning properly.

Rheumatic fever is related to a bacterial infection. Usually, when bacteria enter our body, the immune system develops defense mechanisms in the form of antibodies and activated white cells that destroy the bacteria. Common throat infections are caused by viruses. In about 15% of cases, a bacterium called Streptococcus is involved. As usual, antibodies and white cells would usually fight the infection, however in some people, these defense mechanisms don't go according to plan. . The tissues in the heart, brain and joints have certain characteristics similar to that of Streptococcus and the white blood cells and start attacking the patient's own tissues.

Rheumatic fever is not directly caused by the bacteria but because of the altered immune response to it.


What are the symptoms of rheumatic fever?

Fever and fatigue

Joint Pain. Usually involves larger joints like knee, ankle and elbow and at multiple sites, are affected, swollen, red and painful. At times, the typical changes may be seen only with one joint while other joints might be painful but not swollen.

Small nodules, hard, round swellings under the skin. Rare.

Reddish patches especially over the trunk and proximal parts of the limbs. Rare.

Heart - Excessive chest and neck pulsations.

All these symptoms may resemble other conditions so always consult a doctor if one of your children notices these symptoms.


Not everyone with a Streptococcal throat infection will develop rheumatic fever? Usually only in about 3% individuals with sore throat are affected.

Children in the age group of 5-15 years are particularly susceptible but it can affect children as young as three. It' very rare after about 4 years of age.

We can prevent the rheumatic fever by treating throat infections with antibiotics for adequate duration. With general improvement in the living conditions, the incidence of Streptococcal throat infection and rheumatic fever decreases.

9 comments:

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