RHEUMATIC

HEALTHCARE SERVICES

FEVER
Presented by:
McKelly Bulahan
Kiara Manongsong
Katrina Quintero
 DISEASE PROCESS
Rheumatic fever (acute rheumatic fever) is a disease that can affect the heart, joints, brain, and
skin. Rheumatic fever can develop if strep throat and scarlet fever infections are not treated
properly. Early diagnosis of these infections and treatment with antibiotics are key to preventing
rheumatic fever.

The knees, ankles, elbows, and wrists are the joints most likely to become swollen from rheumatic
fever. The pain often migrates from one joint to another. However, the greatest danger from the
disease is the damage it can do to the heart. In more than half of all cases, rheumatic fever scars
the valves of the heart, forcing this vital organ to work harder to pump blood. Over a period of
months or even years -- particularly if the disease strikes again -- this damage to the heart can
lead to a serious condition known as rheumatic heart disease, which can eventually cause the
heart to fail.
 ANATOMY & PHYSIOLOGY
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.

Group A streptococcus infections of the skin or other parts

of the body rarely trigger rheumatic fever.

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).
 SIGNS AND SYMPTOMS
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
Sore Throat
 TREATMENT / PREVENTION
Treatment on Managing Inflammation, Symptoms
Doctors treat symptoms of rheumatic fever with medicines like aspirin to reduce fever, pain, and
general inflammation. In addition, all patients with rheumatic fever should get antibiotics that treat
group A strep infections. People who develop rheumatic heart disease with symptoms of heart
failure may require medicines to help manage this as well.

Serious Complications Include Long-term Heart Damage

If rheumatic fever is not treated promptly, long-term heart damage (called rheumatic heart
disease) may occur. Rheumatic heart disease weakens the valves between the chambers of the
heart. Severe rheumatic heart disease can require heart surgery and result in death.

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.
 DRUG OF CHOICE
Antibiotic treatment in patients who present with acute
rheumatic fever (ARF) is necessary irrespective of the throat
culture result. Such therapy probably does not alter the risk of
developing rheumatic heart disease but at least minimizes the
possible transmission of a rheumatogenic streptococcal strain.
ANTIBIOTICS
Primary prophylaxis (treatment of streptococcal pharyngitis)
dramatically reduces the risk of ARF and should be provided
whenever a group A streptococcal pharyngitis is confirmed.
Treatment of pharyngitis without proof of group A
streptococcal etiology may be reasonable in areas of high
endemicity
 DRUG OF CHOICE
Anti-inflammatory treatments include  pain medications that
are also anti-inflammatory, such as  aspirin  (Bayer)
or  naproxen  (Aleve, Naprosyn). Though aspirin use in children
ANTI-INFLAMMATORY
with certain illnesses has been associated with Reye’s
TREATMENTS Syndrome, the benefits of using it in treating rheumatic fever
may outweigh the risks. Doctors may also prescribe a
corticosteroid to reduce inflammation.
 Risk Factors
Factors that can increase the risk of
rheumatic fever include:
Family history. Some people carry a gene
or genes that might make them more
likely to develop rheumatic fever.
Type of strep bacteria.  Certain strains of
strep bacteria are more likely to
contribute to rheumatic fever than are
other strains.
Environmental factors.  A greater risk of
rheumatic fever is associated with
overcrowding, poor sanitation and other
conditions that can easily result in the
rapid transmission.
Inflammation caused by rheumatic fever
can last a few weeks to several months. In
some cases, the inflammation causes long-
term complications.
Rheumatic fever can cause permanent
damage to the heart (rheumatic heart
disease). It usually occurs 10 to 20 years
after the original illness, but severe cases
of rheumatic fever can cause damage to
the heart valves while your child still has
symptoms. Problems are most common
with the valve between the two left
chambers of the heart (mitral valve), but
the other valves can be affected.
Complications
 REFERENCES:
Group A Strep. (2018, November 1). Retrieved from
https://www.cdc.gov/groupastrep/diseases-public/rheumatic-
fever.html

Rheumatic fever. (2019, October 10). Retrieved from

https://www.mayoclinic.org/diseases-conditions/rheumatic-
fever/symptoms-causes/syc-20354588

Der Sarkissian, C. (2017, April 2). What is Rheumatic Fever? What

Causes This Strep Throat Complication? Retrieved from
https://www.webmd.com/a-to-z-guides/understanding-rheumatic-
fever-basics

Newman, T. (2018, January 10). Rheumatic fever: Causes, symptoms,

and treatment. Retrieved from
https://www.medicalnewstoday.com/articles/176648.php#symptoms