măt`ĭk), systemic inflammatory disease, extremely variable in its manifestation, severity, duration, and aftereffects. It is frequently followed by serious heart disease, especially when there are repeated attacks. Rheumatic fever usually affects children. It is closely related to a preceding streptococcal infection (e.g., streptococcal tonsillitis or pharyngitis). Some of its symptoms are tenderness and inflammation about the joints, fever, jerky movements, nodules under the skin, and skin rash. If inflammation of the heart, or myocarditis, is mild, there is no permanent heart damage, but if the valves of the heart become inflamed, they may become scarred and deformed, permanently impairing their function. Such heart damage can sometimes be corrected by surgery.
Treatment of rheumatic fever is with penicillin, salicylates, and steroids; extended rest is usually necessary. Rheumatic fever may be prevented by prompt treatment of all streptococcal infections. Cardiac damage may possibly be avoided if prophylactic measures are taken after a first attack of rheumatic fever, i.e., long-term maintenance doses of antibiotics, to discourage streptococcal infections and recurrences of rheumatic fever. Rheumatic fever has declined in incidence in the industrialized countries, but has increased in prevalence in the Third World. See also streptococcus streptococcus (strĕp'təkŏk`əs), any of a group of gram-positive bacteria, genus Streptococcus,
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rheumatic fever
Generalized disease caused by certain types of streptococcus bacteria. It occurs mostly in children and young adults. Symptoms may be mild or severe. Sudden fever, joint pain, and inflammation may begin days to weeks after a streptococcal infection, usually of the throat (see pharyngitis). Other symptoms may include skin nodules and rashes, chorea, abdominal pain, nosebleeds, and weight loss. Heart inflammation, with accompanying rapid heartbeat, murmurs, and enlargement, can lead to valve scarring, markedly shortening life. After recovery, survivors are prone to future attacks. Penicillin given when the initial infection is diagnosed can prevent it. Otherwise, salicylic acid derivatives or corticosteroids help the symptoms.
rheumatic fever
Rheumatic fever
An illness that follows an upper respiratory infection with the group A streptococcus (Streptococcus pyogenes) and is characterized by inflammation of the joints (arthritis) and the heart (carditis). Arthritis typically involves multiple joints and may migrate from one joint to another. The carditis may involve the outer lining of the heart, the heart muscle itself, or the inner lining of the heart. A minority of affected individuals also develop a rash (erythema marginatum), nodules under the skin, or Sydenham's chorea (a neurologic disorder characterized by involuntary, uncoordinated movements of the legs, arms, and face). Damage to heart valves may be permanent and progressive, leading to severe disability or death from rheumatic heart disease years after the initial attack. The disease occurs an average of 19 days after the infection and is thought to be the result of an abnormal immunologic reaction to the group A streptococcus. Initial attacks of rheumatic fever generally occur among individuals aged 5 to 15. Those who have had one attack are highly susceptible to recurrences after future streptococcal infections.
Initial attacks of rheumatic fever can be prevented by treatment of strep throat with penicillin for at least 10 days. Patients who have had an episode of rheumatic fever should continue taking antibiotics for many years to prevent group A streptococcal infections that may trigger a recurrence of rheumatic fever. See Streptococcus
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