Dr.Kamini Silvarajan MD/AAAM

Editorial Board: Kamini Silvarajan MD/AAAM

Rheumatic fever

Rheumatic fever is affecting many people throughout the world, yet many people are not aware about this disease. Generally, people think that this is some sort of fever, by looking at its name, but this is one of the most important conditions related to the heart.

Rheumatic fever is a type of hypersensitivity reaction. Hypersensitivity is the abnormal or excessive reaction of the immune system to certain particles called antigens. Antigens are any substances, which your body recognizes as being foreign to your body, or as foreign particles. Rheumatic fever is a type 2 hypersensitivity reaction.

Why is Rheumatic fever caused?

Rheumatic fever is caused due to the infection of the body with a bacteria called Group A beta hemolytic streptococcus or Streptococcus pyogenes. This Bacterium enters the body from sore throat or when having certain types of skin infection, which enters the body through the wounds.

So, we need to be really careful when we suffer from sore throat or wounds on the skin. If we are not careful, we might end up getting rheumatic fever. We need to consult a doctor immediately and take some antibiotics to kill the infection, and to prevent further damage.

Both the bacteria and our body have some type of proteins, which are quite similar in their structure. Our body has protein C and the bacteria have protein M, which look similar. So, our immune system gets confused and starts acting on our own body, by producing auto-antibodies against our body. This causes damage to our body cells.

Who suffers from Rheumatic fever?

Rheumatic fever usually affects the kids who are between the ages 5 to 15 years. This disease mainly affects the people in their adolescence, but sometimes it occurs in older people too. As, it’s very common among the kids, we need to be very careful when kids get sore throat or wounds, which are very common among them.

How is Rheumatic fever diagnosed?

Rheumatic fever is diagnosed mainly based on the Jones criteria for Rheumatic fever. It has both major and minor criteria. Let us talk about them.

Major criteria for diagnosis of Rheumatic fever

1. Arthritis

2. Carditis

3. Subcutaneous nodules

4. Erythema marginatum

5. Sydenham's chorea

Minor criteria for the diagnosis of Rheumatic fever: 

  1. Fever
  2. Arthralgia or joint pains
  3. Elevated levels of CRP or C-reactive protein in blood
  4. Increased PR interval in the ECG
  5. Increased Total lung capacity or TLC
  6. Increased Erythrocyte Sedimentation rate or ESR

Essential criteria for the diagnosis of Rheumatic fever:

There are also criteria called the essential criteria, which are absolutely essential for the diagnosis of Rheumatic fever like: 
  1. Positive culture of the bacteria on throat swab.
  2. Elevated levels of Antistreptolysin O antibodies or ASO titers in the blood.
  3. History of recent streptococcal infection.
Presence of 2 major and essential criteria confirms the diagnosis of rheumatic fever. The presence of 1 major criterion, 2 minor criteria and also the essential criteria also confirms the diagnosis of Rheumatic fever – By Dr.Deepti

In rheumatic fever, many organs in the body are affected. Heart is the major organ affected by the disease. In Rheumatic fever, heart is swollen in all its layers, and the patient's ECG, which is the recording of the patient’s heart also shows many changes. The patient has chest pain, as the heart is affected. The doctor can hear abnormal heart sounds during auscultation or checking with stethoscope.