Rheumatic Fever and Complications

Rheumatic fever is an inflammatory disease. Group-A Streptococcal infection of the throat or pharyngitis may lead to acute rheumatic fever. Central nervous system, skin, joints and the heart are predominantly affected by rheumatic fever. Young children in the age group of 5 to 15 years are usually affected by acute rheumatic fever. The incidence rate is about 3% in the patients with acute Streptococcal pharyngitis and the latent period is about 2 to 3 weeks. There is a need for throat swab culture to find out the type of bacterial infection in cases of acute pharyngitis or tonsillitis. A positive throat swab culture for group-A Streptococcal infection is considered as the direct evidence of throat infection. Antibiotics are the choice of drug to eradicate group-A Streptococci. The antibiotics could be given even if the throat swab is negative for Streptococci since the organisms may be present in the areas inaccessible to the swabs. The patient may have moderate to high grade fever with skin rash or arthralgia. Inappropriately treated cases may develop endocarditis, polyarthritis, chorea or subcutaneous nodules. There may be transient or persistent rise in 'erythrocyte sedimentation rate' (ESR). The test for acute phase protein called carbohydrate reactive protein (CRP) is also found to be positive in addition to elevated levels of 'Anti-Streptolysine-O' (ASO) antibodies. The patient needs specialized consultation and adequate treatment to avoid serious complications.