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PAEDIATRIC RHEUMATIC FEVER: AGGRAVATED

Dr. Sudeep Verma, Tuesday, August 25, 2020

WHAT IS PAEDIATRIC RHEUMATIC FEVER?

Paediatric Rheumatic Fever (PRF), also know and Acute Rheumatic Fever (ARF), is an abnormal immune reaction to group A streptococcal (strep) infections. This infection often occurs in the throat and may be known as strep throat. Some researchers believe that ARF may also occur after group A streptococcal (strep) infections of the skin. The exact immune mechanism of ARF is still being studied.

PRF is most commonly between the ages of 5 – 20 years, though episodes of PRF have been recorded in children as young as 3 years or in adults into their 30s.


WHAT ARE THE RISK FACTORS?

Risk factors for ARF are generally considered in three main categories:

  • Environmental Factors: Including overcrowding, limited nutrition, limited access to health services.
  • Individual Factors: Genetics or a family history PRF or RHD (Rheumatic Heart Disease) may increase the risk of developing ARF after a strep throat infection. Research to understand the effect of genetics on ARF risk is underway around the world.
  • Bacterial Factors: Some strains of the strep bacteria are more likely to cause PRF than others. Testing to identify different strains of GAS infection can difficult and is more often used in research than clinical practice. Globally, PRF and RHD are more common in indigenous communities than non-indigenous communities. Disparity may be very pronounced.

 

WHAT ARE THE SYMPTOMS OF PRF?

Symptoms of PRF usually begin two or three weeks after a strep infection. The most common symptoms of PRF are:

  • Joint pain
  • Fever
  • Temperature greater than 38°C / 100.4°F
  • Feeling sick
  • Skin changes
  • Abnormal movements or body parts or changes in mood

Symptoms of ARF usually last for one or two weeks. Abnormal movement symptoms may last for longer.


WHAT IS THE DIAGNOSIS OF PRF?

There are no specific blood tests or scans to test for PRF. Instead, doctors and health workers use lots of a different kind of information to decide whether someone has ARF. Once all the information has been gathered doctors can use guidelines to determine whether someone has ARF. Tests may include:

  • Physical Examination
  • Blood Tests
  • Heart Tracing (ECG or EKG)
  • Heart Scan (echocardiography, echo)


WHAT IS THE TREATMENT PRESCRIBED?

Some people with PRF will only require pain medicine for joint pain and fever. Symptoms of PRF usually begin to improve after a few weeks.

PRF can cause inflammation of the heart valves and muscle. This can cause heart failure when the heart is unable to pump blood effectively. In this case, people with bed rest may need medicines for heart failure and bed rest. A small number of people may need heart surgery for PRF.

The most important treatment of PRF is the prevention of further episodes to prevent the development of RHD. This is known as secondary prophylaxis usually means having regular antibiotic injections.


WHY KIMS?

KIMS, one of the best paediatric cardiac hospitals in Hyderabad, has a complete and sophisticated treatment for paediatric rheumatic fever. Our best cardiac specialist for paediatrics in Hyderabad will treat the patients with a course of antibiotics, anti-inflammatory medications, and a period of bed rest (often between two and twelve weeks). To reach more people, our best paediatric heart doctors in Madhapur are always available to help your children recover with a smile.

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