Acute rheumatic fever is an inflammatory disease that can involve multiple systems and occurs in predisposed children a few weeks after a throat infection (pharyngitis) caused by bacteria called group A beta hemolytic streptococcus. It is suggested that the abnormal immune system response to the building blocks of the bacteria is caused by targeting the child's heart, joints, brain, skin and subcutaneous tissues. The disease is popularly known as cardiac rheumatism.
Who gets it?
The disease usually affects children between the ages of 5 and 15. Acute rheumatic fever occurs in only 1-3% of people who have a throat infection due to beta hemolytic streptococcus. It is a common disease throughout our country, especially in the Southeastern Anatolia Region. Rheumatic fever is more common in winter and spring months and in people living in crowded environments.
What are the signs and symptoms?
Movering joint pain and swelling involving more than one joint. (joint rheumatism), inflammation of the heart valves, walls and membranes (cardiac rheumatism), behavioral changes, involuntary movements in the arms and legs, skin rash, pea-sized swellings on the outer surface of the joints and the subcutaneous tissue in the hair area, and fever are important findings of the disease. Patients may have one or more of these symptoms. While findings in other organs usually heal without leaving any damage, cardiac rheumatism can turn into permanent rheumatic valve disease. If the problem in the heart valves is mild, it does not cause any heart-related complaints in the child, but in children with serious valve problems, signs of heart failure such as fatigue, weakness, shortness of breath and edema may be observed.
How is it diagnosed?
How is it diagnosed?
How is it diagnosed? strong>
The signs and symptoms listed above are detected in the patient, tests are performed to show the level of inflammation in the blood and whether the bacteria that cause the disease is encountered, a throat culture is taken and an electrocardiogram is taken. By evaluating the compliance of the obtained findings with the criteria agreed upon by many doctors from different countries, called the updated modified Jones criteria, the patient was diagnosed with acute rheumatic fever. The person is placed. Some patients who have no heart-related signs or symptoms and no murmurs are diagnosed only when cardiac involvement is demonstrated by echocardiography. Again, some patients who are not diagnosed initially due to the mild course of the disease are diagnosed with the help of echocardiography only after rheumatic valve disease develops.
How is it treated?
Aspirin in the early stages of the disease. or calm widespread inflammation with anti-inflammatory medications such as cortisone. When inflammation is evident, the patient is placed on bed rest for a few weeks. Penicillin injections are recommended every three weeks to prevent the disease from recurring. In the presence of severe rheumatic valve disease, heart failure is tried to be controlled with diuretic drugs and drugs that reduce the afterload of the heart. In people with serious valve problems, their heart valves may need to be treated surgically. Expansion of valve stenosis that develops especially in adulthood can be attempted with balloon valvuloplasty.
In conclusion, since acute rheumatic fever can lead to permanent and serious disorders in the heart, it should not be neglected and in the presence of suspicious findings, the child It is a disease that needs to be evaluated by cardiologist.
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