By rheumatic fever the immune system attacks acutely tissues in the body and causes swelling, pain and damages. Most often the skin and joints are attacked. Often also the heart is the target of attack and here the condition can cause severe anatomical damages and functional problems, sometimes life-threatening.
THE CAUSES AN MECHANISMS OF THE DISEASE
The conditions mot often occurs as a complication to a bacterial infection, usually in the airways, and by the type of bacteria called hemolytic streptococs. In typically occur accutely 1-3 weeks after the infaction itself is mostly over and typically and the accute period typically lasts a few weeks. After that period there may be a chronic period with les symptoms or recurring accute periods, usually triggered by new infections.
One thinks that the condition occurs because proteins at the cell surface of the bacteria resamble proteins in body tissues and that the immune system therefore also reacts against body proteins.
The condition also may occur because products from the bacteria attach themselves chemically to structures in the body tissues. The immune system then recogizes the chemical complexes thus formed as something foreign and attack the sells where these complexes are attached.
SYMPTOMS AND CONSEQUENES OF RHEUMATIC FEVER
General symptoms from the condition is fever, lathargy and strong sweathing. There is often paun in the stomach.
Symptoms from the skin are reddened areas or small round red spots. Some patients get small lumps or knots in the deeper layers of the skin.
The joints will show symptoms of inflammation, especially swelling, redness and elevated temperature. Joints often affected are the knees, elbows, and wrists.
All layers in the heart can be attacked. Cardiac symptoms are rapid heart beat, murmers by auscultation, breaxt pain and altered patterns by EEG. The heart may work weakly which will give more severe general symptoms.
Anatomical damages can develop, but usually slowly, often during everal years. Especially the valves in the heart can be severely damaged, which result in severe heart malfunction.
PREVENTION AND TREATMENT OF RHEUMATIC FEVER
The most important prevention of the condition is to combat the infection effectively by antibiotics, and to hinder new infections to occur. If the infetion still occurs by the onset of rheumatic fever, the best treatment is getting rid of the infection as soon as possible.
By all chronic conditions a healthy diet plays a crucial role for the prevention and cure, and also by rheumatic fever.
In the accute face non-steroid drugs against pain and fever is used. If the heart is affected, the pasient is ordered to avoid physical strain.
By hard affliction upon the heart, it is common to order the patient to stay in bed until the inflammation in the heart is over. This can in some cases take months or years. In these cases the patient may be ordered to stay in bed for months or years. One must however wonder if such a strict regime will do more harm to the patient after a few weeks that good, or even contribute to death, since that degree of inactivity will also gravely weaken the physiology.
If the cardiac valves are seriously damaged, surgery to correct or replace the valves can be done.
FREQUENCY OF RHEUMATIC FEVER
The frequency of rheumatic fever seems to be proportional to the frequency, everity and length of streptococcal infections in the population. In the weatern countries, especially the length and severity of these infections have gone down due to effective treatment by antibiotics, and hence the condition is more seldome than before.
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