Understanding how sore throat could lead to rheumatic fever

Understanding how sore throat could lead to rheumatic fever

Dr. Rotimi Adesanya<

Rheumatic fever can occur after a throat infection from a bacteria called group A streptococcus. Group A streptococcus infections of the throat cause strep throat or less commonly scarlet fever.

It is an inflammatory disease that develops from strep throat or scarlet fever that isn’t properly treated. Strep throat and scarlet fever are caused by an infection with streptococcus bacteria. Rheumatic fever mostly affects children and adolescents in low- and middle-income countries, especially where poverty is widespread and access to health services is limited. People who live in overcrowded and poor conditions are at the greatest risk of developing the disease.

It is not too common in adults though they also get rheumatic fever. Rheumatic fever is not contagious. You can’t give it to or get it from someone else. But strep throat and scarlet fever are contagious. These infections spread through respiratory droplets (by coughing or sneezing on someone else).

Symptoms<

The onset of rheumatic fever usually occurs about two to four weeks after a strep throat infection. Rheumatic fever signs and symptoms — which result from inflammation in the heart, joints, skin or central nervous system — can include fever, painful and tender joints — most often in the knees, ankles, elbows and wrists, Pain in one joint that migrates to another joint, red, hot or swollen joints, small, painless bumps beneath the skin, Chest pain, Heart murmur, Fatigue, Flat or slightly raised, painless rash with a ragged edge, Jerky, uncontrollable body movements (Sydenham chorea) — most often in the hands, feet and face.

Causes<

The link between strep infection and rheumatic fever isn’t clear, but it appears that the bacteria trick the immune system. The strep bacteria contain a protein similar to one found in certain tissues of the body. The body’s immune system, which normally targets infection-causing bacteria, attacks its own tissue, particularly tissues of the heart, joints, skin and central nervous system. This immune system reaction results in swelling of the tissues (inflammation).

Complications<

If your child receives prompt treatment with an antibiotic to eliminate strep bacteria and takes all medication as prescribed, there’s little chance of developing rheumatic fever. If your child has one or more episodes of strep throat or scarlet fever that aren’t treated or aren’t treated completely, he or she might develop rheumatic fever. Rheumatic fever can cause permanent damage to the heart, including damaged heart valves and heart failure. Treatments can reduce damage from inflammation, lessen pain and other symptoms, and prevent the recurrence of rheumatic fever. Inflammation caused by rheumatic fever can last a few weeks to several months. In some cases, the inflammation causes long-term complications.

Diagnosis and tests<

If your provider suspects rheumatic fever, they will first swab your throat to check for group a streptococcus bacteria. They may use a rapid strep test or order a throat culture. A rapid strep test can provide results within 10 minutes. A throat culture takes a few days to get results..Depending on your symptoms, your healthcare provider may also order:

Blood tests:< Sometimes, providers order a blood test to confirm a strep infection. Blood tests can detect antibodies, other blood tests check for substances (like proteins) that show inflammation in the body.

Heart tests: <Heart tests, such as an electrocardiogram (ECG) or an echocardiogram (Ultrasound of the heart), help providers check your heart function.

Treatment and prevention<

The only way to prevent rheumatic fever is to treat strep throat infections or scarlet fever promptly with a full course of appropriate antibiotics.

Antibiotics: <Health care providers prescribe antibiotics to treat the underlying bacterial infection. Some antibiotics are one injection (shot). Others you take by mouth for a week or more.

Anti-inflammatory medications: <Your provider will likely recommend medication, such as aspirin, to reduce inflammation (swelling) throughout the body. This medication may also relieve symptoms, such as joint pain. For severe symptoms, your provider may prescribe a stronger medication (corticosteroids) to fight inflammation.

Other therapies: <Rheumatic fever can affect people in different ways. Your provider may recommend other treatments based on how the condition affects you. In severe cases, you may need heart surgery or joint treatments to treat serious complications.

Practicing good hygiene can reduce your chances of getting a bacterial infection. It can also stop you from spreading an infection to someone else. You should always:

  • Wash your hands often (and well) with soap and water.
  • Cough or sneeze into a tissue, your elbow or upper shoulder (not your hand).
  • Use a tissue once for a sneeze or to blow your nose, then throw it away and wash your hands.

Dr. Rotimi Adesanya is a child and public health physician<

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