Wednesday, April 26, 2017

RHEUMATIC FEVER: understanding, symptom, Cause, diagnosis, Treatment and complication

Understanding Rheumatic Fever

Rheumatic fever is a complication that occurs when an infection caused by group A streptococcal bacteria is not handled thoroughly. Examples of diseases caused by group A streptococcus include a sore throat and dengue fever.
This serious condition can be experienced by anyone. However, the most common age group was 5-year-olds to 15-year-olds.
RHEUMATIC FEVER: understanding, symptom, Cause, diagnosis, Treatment and complication

Symptoms of Rheumatic Fever

Rheumatic fever is a complication of strep throat, and the disease usually occurs within 7 days to 1 month after the person has a throat infection. A number of common rheumatic fever symptoms include:
  • Arthritis is most common in the ankles, knees, wrists, and elbows.
  • Carditis or inflammation of the heart with indications of a persistent cough, chest pain, shortness of breath, rapid heartbeat, and always feel tired. These symptoms most commonly affect children and can be fatal.
  • Sydenham chorea, characterized by inflammation of the nervous system. Symptoms that can arise include an uncontrolled twitch or jerk, a disturbance of balance, and an unusual outburst of emotion or behavior (such as sudden cry or laughter).
  • Rash on the skin without pain or itching.
  • Fever.
  • Small bumps that appear under the skin.
These symptoms will gradually recover within a few weeks to several months. But specifically for carditis, the symptoms can last up to a maximum of 2 years.
Rheumatic fever has the potential to trigger serious complications. Therefore, take your child to the doctor if you have a throat infection in order to get the right handling and fast.

Causes of Rheumatic Fever

Group A streptococcus bacteria do not cause rheumatic fever directly. This complication occurs due to excessive reactions of our immune system to these bacteria.
Experts suspect that there is one protein in group A streptococcal bacteria that is similar to the protein arrangement in certain tissues. Therefore, our immune system also attacks the body tissues of people with bacteria.
There is also another theory which says that certain groups of people are born with genetic abnormalities that cause the immune system is unable to work perfectly at the time of a throat infection, resulting in excessive inflammatory reaction to the heart, joints, skin, and nervous system.

Rheumatic Fever Risk Factors

There are several things that are thought to increase the risk of rheumatic fever. These risk factors include:
  • Age . Rheumatic fever most commonly affects children and adolescents, precisely at the age of 5 to 15 years.
  • Environmental factors. Densely populated areas with poor hygiene have a higher risk of causing the spread of rheumatic fever.
  • Type of streptococcal bacteria. Rheumatic fever is most common after strep throat infections due to group A streptococcal bacteria.

Diagnosis of Rheumatic Fever

Due to its various symptoms, the process of diagnosis of rheumatic fever will be determined by the Jones Criteria. This criterion is divided into 2 categories, namely major and minor symptoms.
Major criteria are the most common symptoms that usually occur in people with rheumatic fever. These symptoms include carditis, arthritis, Sydenham chorea, rashes and lumps on the skin.
While the minor criterion is a symptom that is sometimes experienced by the person. Some of these are joint pain, fever (usually more than 39 ° C), irregular heartbeat, and blood test results that show high levels of inflammation.
Rheumatic fever diagnosis can usually be established if the patient has at least two major criteria, or at least two minor criteria plus one major criterion.
To confirm the diagnosis, the doctor may recommend a series of checks, including:
  • Electrodiagram to measure electrical activity in the heart so that doctors can see the presence or absence of heart rhythm abnormalities.
  • Blood tests for example to check for the presence of antibodies and levels of inflammatory cells due to group A streptococcal infection.
  • Echocardiogram which is useful to see the condition of the heart visually using sound waves, so that the deformity and structure of the heart can be identified.

Rheumatic Fever Treatment

To date, rheumatic fever has no specific medical treatment. The method of treatment performed aims to:
  • Relieve symptoms.
  • Eradicate group A streptococcal bacteria.
  • Prevents serious complications as well as permanent damage to the patient's body.
  • Avoids the recurrence of rheumatic fever.
Some handling steps provided by doctors generally include:
  • Get enough rest. This step will help ease the burden on the heart so it can relieve symptoms.
  • Antibiotics to kill all remaining streptococcal bacteria in the body of the patient and prevent the recurrence of rheumatic fever. Prevention is usually recommended by administering antibiotics every 2-3 weeks. This step generally lasts for a minimum of 5 years or up to 21 years of age. However, people with heart inflammation require a longer duration, which is about 10 years or more.
  • Anti-inflammatory drugs for example nonsteroidal antiinflammatory drugs. This type of drug serves to relieve symptoms such as pain and swelling of the joints and inflammation of the heart.
For a child with Sydenham chorea, you can move it into a quiet, quiet room to keep the symptoms down. If needed, the doctor will administer epilepsy drugs to deal with severe Sydenham chorea indications.

Complications of Rheumatic Fever

Inflammation due to rheumatic fever may last for several weeks to months. In some cases, even people with long-term complications of rheumatic heart disease.
This complication arises when there is damage to the heart valves due to inflammation that interfere with the smooth flow of blood to the heart. In addition, rheumatic heart disease can also lead to further complications, including stroke and heart failure.
The healing rate of rheumatic fever depends on the presence or absence of significant cardiac damage. If there is no cardiac damage, people are likely to recover by undergoing long-term antibiotic treatment that also prevents recurrence. While most people who suffered heart damage will not be able to heal again.

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