Rheumatic Fever

من طرف elmagic الأحد ديسمبر 20, 2009 6:06 pm

Pediatric Arthritis & Other Rheumatic Diseases

Rheumatic Fever

What is rheumatic fever?

Rheumatic fever is a complicated, involved disease
that affects the joints, skin, heart, blood vessels, and brain. It is a
systemic immune disease that may develop after an infection with
streptococcus bacteria, such as strep throat and scarlet fever.

What causes rheumatic fever?

Rheumatic fever is a delayed, autoimmune reaction
to the streptococcus bacteria. It can be prevented with prompt
diagnosis of strep throat, and treatment of strep throat with
antibiotics. It is uncommon in the US, except in children who have had
strep infections that were untreated or inadequately treated.

What are the symptoms of rheumatic fever?

The symptoms of rheumatic fever usually start
about one to five weeks after your child has been infected with
streptococcus bacteria. The following are the most common symptoms of
rheumatic fever. However, each child may experience symptoms
differently. Symptoms may include:

joint inflammation - including swelling, tenderness, and redness
over multiple joints. The joints affected are usually the larger joints
in the knees or ankles. The inflammation "moves" from one joint to
another over several days.
small nodules or hard, round bumps under the skin
a change in your child's neuromuscular movements (this is usually
noted by a change in your child's handwriting and may also include
jerky movements)
rash - a pink rash with odd edges that is usually seen on the trunk of the body or arms and legs.
fever
weight loss
fatigue
stomach pains

Symptoms of rheumatic fever may resemble other medical conditions. Always consult a physician for a diagnosis.

Who is at risk for developing rheumatic fever?

Children ages 5 to 15, particularly if they
experience frequent strep throat infections, are most at risk for
developing rheumatic fever. Rheumatic fever is also more common in
children who have a family history of the disease. There is an
increased prevalence of rheumatic fever in the winter and spring, as
strep throats occur more frequently during these seasons. Strep
infections are contagious, but rheumatic fever is not.

How is rheumatic fever diagnosed?

In addition to a complete medical history and
physical examination, rheumatic fever is diagnosed by your child's
physician based on the presence of criteria found in the revised Jones
criteria diagnostic tool (standard guidelines for diagnosis of
rheumatic fever):

Major criteria include:
- carditis (inflammation of the heart)
- polyarthritis (inflammation of more than one joint)
- chorea (unusual jerky movements, most often involving the face and hands)
- subcutaneous nodules (small, painless bumps under the skin, often over bony areas)
- rash (a red, irregular rash on the trunk)

Minor criteria include:
- fever
- arthralgia (pain in one or more joints)
- previous rheumatic carditis (inflammation of the heart)
- changes in the electrocardiogram (EKG) pattern
- abnormal sedimentation rate or C-reactive protein (laboratory tests performed on blood)

The diagnosis of rheumatic fever can be made when
two of the major criteria, or one major criterion plus two minor
criteria, are present along with evidence of a streptococcal infection.

There is no definitive test to diagnose rheumatic
fever. Blood work is also usually done to assist in making a diagnosis.
Your child's physician may also order an electrocardiogram, or EKG (a
test that records the electrical activity of the heart, shows abnormal
rhythms - arrhythmias or dysrhythmias - and detects heart muscle damage
of the heart) as part of the diagnostic process for rheumatic fever. A
throat culture may also be done to determine if the child tests
positive for streptococcus bacteria, although during the initial phase
of rheumatic fever, the throat culture is often negative.

Treatment for rheumatic fever:

Specific treatment for rheumatic fever will be determined by your child's physician based on:

your child's overall health and medical history
extent of the reaction
your child's tolerance for specific medications, procedures, or therapies
expectations for the course of the reaction
your opinion or preference

Children with rheumatic fever are often treated in the hospital, depending upon the severity of the disease.

Treatment for rheumatic fever, in most cases, combines the following three approaches:

treatment for streptococcus infection
The immediate goal is to treat the infection with antibiotics. This is
done even if the throat culture is negative. Following the initial
treatment for strep infection, your child may continue to receive
monthly doses of antibiotics to help prevent further complications.
anti-inflammatory medications
Based on the severity of your child's condition, your child's physician
may prescribe medications to help decrease the swelling that occurs in
the heart muscle, as well as to relieve joint pain.
bed rest
The length of bed rest will be determined by your child's physician,
based on the severity of your child's disease and the involvement of
the heart and joints. Bed rest may range from two to twelve weeks.

Are there any complications from having rheumatic fever?

Depending on the severity of the initial attack of
the disease on the heart, some children may develop heart disease.
Physical activity and sports may be restricted in your child, based on
your child's physician's findings.

Also, if your child had heart involvement during
the initial course of rheumatic fever, he/she will need to receive
antibiotics before having dental work done. This helps decrease the
chance of infection migrating to the heart during the dental procedure.
Consult your child's physician for more information.

Can my child develop rheumatic fever again?

Yes, although the chances are reduced because of
the use of antibiotics after the initial disease process. The greatest
chance of recurrence is during the first three years. The chance of
developing the disease again decreases with age and time since the
first attack.

After having rheumatic fever, your child will need
medications on a monthly basis to help decrease the chance of
developing rheumatic fever again. Usually by the time your child is 18
and your child's physician feels he/she is not at risk for developing
heart disease, the antibiotic therapy may be stopped. Close follow-up
with your child's physician is needed.

من طرف essraa allawy الأحد ديسمبر 27, 2009 3:18 pm

thank you majic

Rheumatic Fever

Rheumatic Fever

رد: Rheumatic Fever