Although we still do not know the exact cause of rheumatic fever, medical science has accumulated a great many facts about the disease. It is a delayed result of a streptococcal infection, such as sore throat, scarlet fever, tonsillitis, or middle ear infection, which may still be present when rheumatic fever strikes, but which more often has disappeared before the rheumatic fever itself becomes evident.
The early signs of the disease usually begin 10 to 14 days after the streptococcal infection and consist of a fever ranging between 101° and 103° F. (38.3° and 39.4° C), irritability, striking pallor, moderate weight loss, and poor appetite. More specific symptoms then appear. There is pain in the joints, which are tender to the touch and hurt when moved. Redness and swelling of the joints occur.
The heart may become damaged, causing a weak and rapid pulse, shortness of breath, and a puffy face. Often, blood-vessels in the nose are weakened, leading to nosebleeds. Various rashes may appear.
A special form of rheumatic fever is Sydenham’s chorea, commonly known as Saint Vitus’s dance, which most often affects children between the ages of 6 and 11, particularly girls. A rash caused by the fever may appear on the body. Involuntary twitching or writhing movements occur. (These symptoms must not be confused with ordinary nervousness.) Fortunately, with good medical care, chorea clears up.
Prevention of rheumatic fever
The key to prevention of rheumatic fever is the recognition of streptococcal infections. Early diagnosis by a doctor and prompt treatment with penicillin and other antibiotics are most important.
When a person has had rheumatic fever once, everything possible must be done to prevent him from getting repeated attacks, because of the damage it may do to the heart. The most essential factor is the prevention of other streptococcal infections. This is done by the use of monthly injections of long-acting penicillin or the daily administration of penicillin or sulpha medicines.
Heart murmurs
Murmurs are caused by changes in the heart valves and by the blood leaking from scarred valves that do not close properly. Murmurs are not always due to rheumatic fever; and a heart only very slightly affected with rheumatic fever may give a loud murmur.
It is up to the doctor and not the parents to decide when the child’s heart is healed, and he may become normally active. If there is any doubt, consult a heart specialist (cardiologist).
*204\68\2*
