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Rheumatic Fever

Rheumatic fever is a serious disease that mainly affects children and young adults. It is due to an allergic condition that attacks the connective tissues of body causing joint pains, skin lesions, st. vitus dance due to central nervous system irritation and lastly affects the valves of heart. So it is said that rheumatic fever(disease). ” Bites the heart and leaks to the joint”. Certain strep to coccus germs(Gram positive Cocci) present in the throat are apparently responsible for this. The body becomes highly sensitive to their presence & it is this allergic response that harms the child.

Signs and Symptoms:

In most cases the child develops a sore throat, may have fever, aching pain in joints, lack of appetite, profuse sweating and a skin rash. There is infection of tonsil causing tonsillitis, while recovery, one or two o his larger joints become red, swollen and tender to touch. Tender nodules may appear on the skin particularly over certain joints. Nose bleeding may occurs in some cases. If left untreated at this stage pain in chest may develop due to inflammation(Infection) of pericardium( Covering layer of heart) and heart muscles itself. The child may develop pneumonia, pleurisy and abdominal pain. The child may have involuntary hand movements which is rapid, jerky and irregular. The patient has a tendency to drop things from hand. It usually appears commonly in young girls. This type of hand movement is known as st. vitus dance. There may be muscle weakness and difficulty in chewing and swallowing.

In some children the disease may be low grade, smouldering type with few definite signs. Child is not well, easily fatigued, may not gain weight.

There is rapid pulse, low grade fever, then complaining of growing pain in muscles, joints and over heart region in chest. Such complaining may be taken seriously. The child should be put to bed till he is well. School is much less important than his future health.

Diagnosis:

Besides clinical examinations by a doctor the following tests are essential for sure diagnosis of rheumatic fever.

  •  Culture and sensitivity test of throat swab – It is essential to do a throat swab culture to ascertain the strep to cocci germs in throat. The surface covering of this organism which is known as ‘M’ protein is responsible for allergic and rheumatic disease.
  • A.S.O. Test – Anti-Streptolysin ‘O’ is a substance present in blood serum of patients suffering from streptococcal germs responsible for rheumatic fever. Higher the titre of A.S.O. indicates Rheumatic disease.
  • C.R.P. Test – reactive protein test is another proof of streptococcal infection and helps in diagnosis rheumatic fever.
  •  E.S.R – Erythrocyte Sedimentation rate is quite higher in Streptococcal infection leading to Rheumatic disease.
  • Total White Blood Count(T.W.B.C) is also quite high in such cases.
  • X-ray chest indicates rheumatic heart whether enlargement of heart due to valve damage.

Treatment:

This includes bed rest, good nursing care, diet usually liquid and soft diets during early stages of liquids during high fever and penicillin either in forms of tablets or injections according to severity of disease. Penicillin  is the drug of choice and kills the streptococcal germs responsible for rheumatic fever and disease with its various manifestations. Timely advice of your doctor is necessary for full cure of the disease.

Prevention:

  • Parents should be careful for sore throat and Tonsillitis of children.If such infection, then investigation like throat swab culture, A.S.O., C.R.P., E.S.R. & blood count may be done to ascertain the cause of infection(Whether streptococcal germs).
  • Timely Throat swab culture of school children remaining in hostels to be done to find out streptococcal germs in their throat. If any children have this, they should be treated effectively with penicillin. This measure may be taken in gathering(sports hostels), crowding living, places, unhygienic hostels and boarding.
  • Children should avoid dusty and unhygienic environments as far as possible and should not be drenched repeatedly in rain water during rainy days.
  • Parents and other close family members should check up themselves in case sore throat in any members since they can infect their children in their house.

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