Rheumatic Fever

There are many types of autoimmune diseases. An autoimmune disease happens when the body attacks itself. In the case of rheumatic fever, it occurs due to an infection from Streptococcus pyogenes. Streptococcus pyogenes causes strep throat and can also cause scarlet fever. Strep throat happens when bacteria colonize in the throat making it painful to swallow and causes it to feel scratchy. Many times Strep throat occurs without any complications. Scarlet fever is also caused by Streptococcus pyogenes and is distinguished by a rash all over the body along with fever, sore throat, and a red “strawberry” tongue (Wikipedia contributors , 2015) . These diseases are often found in children. When Streptococcus pyogenes affects other areas of the body,

like the skin, it can “… trigger rheumatic fever” (Rheumatic fever, 2015).
Normally our bodies can distinguish between a foreign cell and our own very easily. However strep has the ability to blend in. It contains a protein that mimics our own body, therefore, confusing our immune system. This causes our immune system to attack itself causing inflammation. Rheumatic fever affects children and young adults between the ages of 4-18 (Rheumatic Fever, 2013) Symptoms can include:
• Fever
• Painful and tender joints — most often the ankles, knees, elbows or wrists; less often the shoulders, hips, hands and feet
• Pain in one joint that migrates to another joint
• Red, hot or swollen joints
• Small, painless nodules beneath the skin
• Chest pain
• Heart murmur
• Fatigue
• Flat or slightly raised, painless rash with a ragged edge (erythema marginatum)
• Jerky, uncontrollable body movements (Sydenham chorea or St. Vitus' dance) — most often in the hands, feet and face
• Outbursts of unusual behavior, such as crying or inappropriate laughing, that accompanies Sydenham chorea
(Rheumatic fever, 2015).
Some complications arise from having rheumatic fever, these are: damage to hear muscle, valve stenosis, and valve regurgitation.

“Damage to the mitral valve… can [also] cause problems with the heart later in life… [causing]… atrial fibrillation [and] heart failure” (Rheumatic fever, 2015). It is very important to be seen by your doctor about heart complications from rheumatic fever because it can impair your hearts ability to pump blood. In order to see if the heart was affected by rheumatic fever an electrocardiogram would be given by your doctor. Typically the heart can recover if only the muscle has been affected. The problem lies in the valves. However, recurrent rheumatic fever can cause permanent damage (Rheumatic Fever and the Heart, 2015).

After getting rheumatic fever the child is more likely to have another recurrence but can be treated with antibiotics. Rheumatic fever can last between 6 weeks to more than 6 months. Because of this antibiotics can be given even after the disease has passed. It is also important to always finish all prescribed medications to avoid the bacteria from becoming resistant. Some people who were treated for strep throat might not have taken the full course of antibiotics. Making them more susceptible to

infections.
To treat Rheumatic fever your doctor will mostly likely prescribe antibiotics and anti-inflammatory medication. If Sydenham chorea is present, then you will most likely be given anticonvulsant medication to diminish the involuntary movements caused by Sydenham chorea. “Sydenham chorea is a rare neurological disorder characterized by rapid, involuntary, purposeless movements…” (Sydenham Chorea, 2015) According to Medscape, there has been a decline of this disease. Some countries have reported some incidences, but were mainly in underdeveloped countries (Medscape, 2015).
It is always important to talk to your doctor about different ways of preventing disease. Treating strep throat thoroughly can have a significant reduction of rheumatic fever. Strep throat can be treated by antibiotics like erythromycin and penicillin. Also, NSAIDs can be used for fever, pain, or both. Depending on your situation corticosteroids can be used to change how your immune system responds and even some medications that help strengthen your hearts contractions may be prescribed as well. For long term care, once the disease has dissipated, the doctor will advise you to take antibiotics if you will be undergoing any dental work or have any surgeries (Rheumatic Fever, 2015).