Rheumatic fever

Rheumatic fever

Last Reviewed : 12/25/2020
Rheumatic fever

Rheumatic fever (RF), also known as acute rheumatic fever (ARF), is an inflammatory disease that can involve the heart,joints, skin, and brain. The disease typically develops two to four weeks after a streptococcal throat infection. Signs and symptoms include fever, multiple painful joints, involuntary muscle movements, and occasionally a characteristic non-itchy rash known as erythema marginatum. The heart is involved in about half of cases. Damage to the heart valves, known as rheumatic heart disease (RHD), usually occurs after multiple attacks but can sometimes occur after a single attack. The damaged valves may result in heart failure, atrial fibrillation and infection of the valves.

Rheumatic fever may occur following an infection of the throat by the bacteria Streptococcus pyogenes. If the infection is untreated rheumatic fever can occur in up to three percent of people. The underlying mechanism is believed to involve the production of antibodies against a person's own tissues. Some people due to their genetics are more likely to get the disease when exposed to the bacteria than others. Other risk factors include malnutrition and poverty. Diagnosis of RF is often based on the presence of signs and symptoms in combination with evidence of a recent streptococcal infection.

Treating people who have strep throat with antibiotics, such as penicillin, decreases the risk of developing rheumatic fever. In order to avoid antibiotic misuse this often involves testing people with sore throats for the infection, which may not be available in the developing world. Other preventive measures include improved sanitation. In those with rheumatic fever and rheumatic heart disease, prolonged periods of antibiotics are sometimes recommended. Gradual return to normal activities may occur following an attack. Once RHD develops, treatment is more difficult. Occasionally valve replacement surgery or valve repair is required. Otherwise complications are treated as per normal.

Rheumatic fever occurs in about 325,000 children each year and about 18 million people currently have rheumatic heart disease. Those who develop RF are most often between the ages of 5 and 14, with 20% of first-time attacks occurring in adults. The disease is most common in the developing world and among indigenous peoples in the developed world. In 2013 it resulted in 275,000 deaths down from 374,000 deaths in 1990. Most deaths occur in the developing world where as many as 12.5% of people affected may die each year. Descriptions of the condition are believed to date back to at least the 5th century BCE in the writings of Hippocrates. The disease is so named because its symptoms are similar to those of some rheumatic disorders.

We researched this topic for you and found the following best online resources. They are categorized into basic, advanced, and research level based on the extent of information you need. You will be taken to the respective websites by pressing on the links below.


Basic information:

http://www.healthline.com/health/rheumatic-fever health line rheumatic fever

http://www.mayoclinic.org/diseases-conditions/rheumatic-fever/basics/definition/con-20031399 mayoclinic rheumatic fever

https://medlineplus.gov/ency/article/003940.htm medline plus rheumatic fever

http://www.webmd.com/a-to-z-guides/understanding-rheumatic-fever-basics web md understanding rheumatic fever -- the basics

http://www.nhs.uk/conditions/rheumatic-fever/pages/introduction.aspx nhs uk rheumatic fever

http://www.merckmanuals.com/professional/pediatrics/miscellaneous-bacterial-infections-in-infants-and-children/rheumatic-fever merck manuals(professional version) rheumatic fever

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rheumatic-fever better health rheumatic fever

http://www.arthritis.org/about-arthritis/types/rheumatic-fever/ arthritis foundation rheumatic fever

http://www.kidshealth.org.nz/rheumatic-fever kids health rheumatic fever

https://www.heartfoundation.org.nz/know-the-facts/conditions/rheumatic-fever heart foundation rheumatic fever

http://umm.edu/health/medical/ency/articles/rheumatic-fever un iversity of maryland medical center rheumatic fever

http://chealth.canoe.com/condition/getcondition/rheumatic-fever canoe rheumatic fever

http://www.aboutkidshealth.ca/en/healthaz/conditionsanddiseases/inflammatoryconditions/pages/rheumatic-fever.aspx about kids health rheumatic fever

http://www.healthcentral.com/encyclopedia/adam/rheumatic-fever-4020722/overview/ health central rheumatic fever

http://www.healthlinkbc.ca/healthtopics/content.asp?hwid=uf4498abc health link bc rheumatic fever and heart problems

http://www.nytimes.com/health/guides/disease/rheumatic-fever/overview.html?print=1 new york times rheumatic fever overview


Advanced information:

http://emedicine.medscape.com/article/236582-overview medscape rheumatic fever

http://emedicine.medscape.com/article/333103-overview medscape acute rheumatic fever

http://www.medicalnewstoday.com/articles/176648.php medical news today what is rheumatic fever? what causes rheumatic fever?

http://www.medicinenet.com/rheumatic_fever/article.htm medicine net rheumatic fever (acute rheumatic fever or arf)

http://patient.info/doctor/rheumatic-fever-pro patient rheumatic fever

http://www.who.int/cardiovascular_diseases/resources/en/cvd_trs923.pdf world health organisation rheumatic fever and rheumatic heart disease report of a who expert consultation geneva, 29 october–1 november 2001

http://www.dermnetnz.org/topics/rheumatic-fever/ dermnet nz rheumatic fever

https://www.britannica.com/science/rheumatic-fever britannica rheumatic fever

http://www.emedicinehealth.com/rheumatic_fever/page4_em.htm emedicine health rheumatic fever

http://rarediseases.org/rare-diseases/rheumatic-fever/ national organisation for rare diseases rheumatic fever

https://pedclerk.bsd.uchicago.edu/page/acute-rheumatic-fever pediatrics clerckship acute rheumatic fever

http://www.fpnotebook.com/cv/id/actrhmtcfvr.htm family practise note book acute rheumatic fever

http://www.aafp.org/afp/2010/0201/p346.html aha guidelines on prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis by carrie armstrong am fam physician. 2010 feb 1;81(3):346-359.

http://radiopaedia.org/articles/rheumatic-fever radiopedia rheumatic fever



http://www.hindawi.com/journals/jir/2014/614591/ felipe da silva and jozélio de carvalho, “rheumatic fever associated with antiphospholipid syndrome: systematic review,” journal of immunology research, vol. 2014, article id 614591, 6 pages, 2014. doi:10.1155/2014/614591

http://journal.frontiersin.org/article/10.3389/fped.2014.00116/full mini review article front. pediatr., 04 november 2014 | http://dx.doi.org/10.3389/fped.2014.00116 animal models to investigate the pathogenesis of rheumatic heart disease by catherine m. rush et al.,,

http://journal.frontiersin.org/article/10.3389/fped.2014.00148/full review article front. pediatr., 21 january 2015 | http://dx.doi.org/10.3389/fped.2014.00148 the lectin pathway of complement and rheumatic heart disease by marcia holsbach beltrame et al.,

https://ijponline.biomedcentral.com/articles/10.1186/1824-7288-38-61 adams-stokes attack as the first symptom of acute rheumatic fever: report of an adolescent case and review of the literature by nicola carano et al., italian journal of pediatrics201238:61 doi: 10.1186/1824-7288-38-61

http://journal.frontiersin.org/article/10.3389/fped.2014.00126/full clinical case study article front. pediatr., 20 november 2014 | http://dx.doi.org/10.3389/fped.2014.00126 incidental histological diagnosis of acute rheumatic myocarditis: case report and review of the literature by guilherme s. spina et al.,,

https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-5-11 antibiotics for the primary prevention of acute rheumatic fever: a meta-analysis by katharine a robertson et al, bmc cardiovascular disorders20055:11 doi: 10.1186/1471-2261-5-11

http://europepmc.org/backend/ptpmcrender.fcgi?accid=pmc3184125&blobtype=pdf engel me, stander r, vogel j, adeyemo aa, mayosi bm (2011) genetic susceptibility to acute rheumatic fever: a systematic review and meta-analysis of twin studies. plos one 6(9): e25326. doi:10.1371/journal.pone.0025326

https://ped-rheum.biomedcentral.com/articles/10.1186/1546-0096-9-32 post-streptococcal reactive arthritis in children: a distinct entity from acute rheumatic fever by yosef uziel et al., pediatric rheumatology20119:32 doi: 10.1186/1546-0096-9-32

http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3724245/ indian j med res. 2013 apr; 137(4): 643–658.pmcid: pmc3724245 rheumatic fever & rheumatic heart disease: the last 50 years by r. krishna kumar and r. tandon

http://www.scielo.br/scielo.php?script=sci_arttext&pid=s0041-87811999000300004 silva, c. h. m. da et al. - rheumatic fever: a multicenter study in the state of são paulo.rev. hosp. clín. fac. med. s. paulo 54 (3): 85 - 90,1999.

http://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-13-525 improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach by anna p ralph et al., bmc health services research201313:525 doi: 10.1186/1472-6963-13-525

http://www.racgp.org.au/afp/2012/januaryfebruary/rheumatic-fever/ rheumatic fever identification, management and secondary prevention volume 41, no.1, january/february 2012 pages 31-35

http://cid.oxfordjournals.org/content/33/6/806.full rheumatic fever in the 21st century by gene h. stollerman et al., clin infect dis. (2001) 33 (6):806-814.doi: 10.1086/322665


Other helpful resources(support groups):

http://www.rhdaustralia.org.au/what-acute-rheumatic-fever rhd australia


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Presentations/quiz/newspaper articles:

http://www.slideshare.net/kapradh/rheumatic-fever rheumatic fever

http://www.medicalobserver.com.au/medical-news/a-vaccine-for-strep-throat-and-rheumatic-fever-will-be-trialled-in-humans medical observer a vaccine for strep throat and rheumatic fever will be trialled in humans

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