Recurrent Rheumatic fever

Overview of Recurrent Rheumatic Fever

Recurrent rheumatic fever is a complication of an untreated strep throat or scarlet fever caused by the bacterium Streptococcus pyogenes. It usually affects children between ages 5 and 15, but it can also occur in adults. The first episode of rheumatic fever usually follows a strep throat or scarlet fever infection by up to 4 weeks. The signs and symptoms of recurrent episodes are usually milder but relapse can occur months or years after the first episode.

Recurrent rheumatic fever is more serious than the first episode and can involve multiple organs. Common signs and symptoms include unexplained fever, joint pain, swelling and redness, and a rash. Rarely, recurrent rheumatic fever can lead to heart damage and other serious complications. Treatment consists of antibiotics and anti-inflammatory medications. Prevention is the most important measure and includes prompt and adequate treatment of strep throat and scarlet fever.

Signs and Symptoms

Common signs and symptoms of recurrent rheumatic fever include:

• Unexplained fever
• Joint pain, swelling and redness
• A fine, red rash that doesn’t itch
• Abnormal heart rhythm (arrhythmia)
• Nodules (firm lumps) in the joints or on the skin
• Nausea, vomiting, abdominal pain, and diarrhea
• General malaise and fatigue

Complications

Recurrent rheumatic fever can lead to serious complications, including:

• Scarring of the heart, which can lead to heart failure
• Irregular heart rhythm (arrhythmia)
• Blood vessel inflammation (vasculitis)
• Kidney failure

Treatment

Treatment of recurrent rheumatic fever usually consists of antibiotics and anti-inflammatory medications. Antibiotics are used to treat any current or recent infection. Anti-inflammatory medications reduce fever, joint pain, and swelling. They also slow the progression of the disease. In more serious cases, corticosteroids may be prescribed to reduce inflammation and swelling.

Prevention

The best way to prevent recurrent rheumatic fever is to promptly and adequately treat strep throat or scarlet fever. Vaccines have been developed against Streptococcus pyogenes but are not widely available. Vaccines against other types of strep are available in some countries. Regular monitoring of people with rheumatic fever is strongly advised, as relapse can occur months or years after the initial episode.