• Rheumatic Fever: Symptoms, Diagnosis, Prevent and homeopathic Treatment

    Rheumatic Fever

    Acute febrile illness following streptococcal sore throat, and characterized by fleeting arthritis, pancarditis, leucocytosis and raised ESR. Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever. Strep throat and scarlet fever are caused by an infection with group A streptococcus bacteria.

    Clinical Features
    Symptoms
    • History of sore throat over last two weeks.
    • Fever; with chill.
    • Sour perspiration.
    • Malaise.
    • Anorexia.
    • Acute excruciating pain in big joints.
    • Swelling of joints.
    • Fleeting arthritis:
    • Single joint.
    • Seldom involved for more than few days.
    • No residual trace or deformity remains.
    • Another joint gets involved.
    • Painful/tender joints in the ankles, knees, elbows, and wrists
    • Pain in one joint that moves to another joint
    • Red, hot, swollen joints
    • Small nodules (bumps) under the skin that don’t hurt
    • Chest pain
    • Rapid fluttering or pounding chest palpitations
    • Fatigue
    • Nosebleeds
    • Stomach pain
    • Shortness of breath
    • short attention span
    • Sweating
    • Vomiting
    • Flat, slightly raised, ragged rash
    • Jerky uncontrollable hand, feet, face movements
    • Outbursts of crying or inappropriate laughter

    Causes of Rheumatic Fever (Etiology)
    Antecedent infection:
    • Acute streptococcal group-A b-haemolyticus throat or skin infection.
    Predisposing causes:
    • Over-crowding.
    • MaInutrition
    • Poor sanitation.
    • Cold weather
    • Genetic predisposition noted.
    Age: 5-15 years.
    Sex: common in females.

    Signs of Rheumatic Fever
    • Pallor.
    • Pulse: fast.
    • Temperature: 38 0C.39 0C.
    • Rheumatic nodules: Small subcutaneous nodules, At bony prominences.
    • Erythema marginatum on trunk.
    • Joints affected: Knee, ankle, elbow.
    • Affected joint red, swollen, hot.
    • Affected joint extremely tender.
    Cardiac examination
    – Apex: Feeble, In fifth intercostal space, lateral to midclavicular line.
    – S1 accentuated in mitral area.
    – Soft systolic murmur in mitral area.

    Complications of Rheumatic Fever
    • Sydenham’s chorea.
    • Cardiac arrhythmia.
    • Pericarditis.
    • Congestive cardiac failure.
    • Mitral stenosis.
    • valve stenosis—a narrowing of the valve
    • valve regurgitation—a leak in the valve that causes blood to flow in the wrong direction
    • heart muscle damage—inflammation can weaken the heart muscle, which can decrease the heart’s ability to pump blood effectively
    • atrial fibrillation—irregular heart beat (in the upper chambers)
    • heart failure—heart can no longer pump blood to all parts of the body

    Diagnosis (Ducket Jones Criteria)
    One major and two minor, or two major and one minor criteria must be present
    Major criteria
    • Carditis.
    • Polyarthritis.
    • Subcutaneous nodules.
    • Erythema marginatum.
    • Sydenham’s chorea.
    Minor criteria
    • Fever.
    • Polyarthitis.
    • History of rheumatic fever.
    • Raised ASO titer.
    • Raised ESR, CRP, TLC, prolonged P-R interval.
    • checking joints for inflammation
    • listening to heart to check for abnormalities
    • movement tests to determine nervous system dysfunction
    • blood tests for strep bacteria
    • EKG (measures the electric waves of the heart)
    • echocardiography (uses sound waves to produce image of the heart)

    Investigations (Tests and diagnosis)
    Blood:
    – TLC: raised.
    – DLC: polymorphs increased.
    – ESR: raised.
    – ASO titre: raised.
    – CRP: raised.
    Throat swab:
    – Positive for group-A 13-haemolytic streptococcus.
    ECG shows signs of
    – Conduction defects.
    – Myocarditis.
    – Pericarditis.
    X-Ray joint:
    – Nothing abnormal.
    X-Ray chest:
    – Cardiac enlargement.

    Prognosis
    – Subsides within 2 – 6 weeks.
    – Prognosis good, with effective treatment.

    Miasmatic Cleavage
    – Predominant sycotic disorder.

    Therapeutic Aim
    – To control disease activity.
    – To prevent Complications.
    – To prevent recurrence.

    General Management
    – Complete bed rest till pulse rate, ESR are high.
    – Rest to joint by splints, in position of comfort.
    – Gradually initiate activity.

    How to Prevent Rheumatic Fever
    The best way to prevent rheumatic fever is to fully treat all strep throat and scarlet fever infections. Make sure your child completes all prescribed doses of medication. In addition, schedule a follow-up visit to ensure that your child is free from the strep bacteria antibodies.

    Prophylactic Measures
    – General measures to boost immunity.
    – Control of tonsillitis.

    Homeopathic Treatment for Rheumatic Fever

    Prophylactic
    – Baryta Carbonica.
    – Calcarea Carbonica.
    – Silicea.
    – Streptococcinum.
    – Sulphur.
    – Tuberculinum.
    Symptomatic:
    – Abrotanum.
    – Aconite.
    – Apis Mel.
    – Arsenicum Album.
    – Belladonna.
    – Bryonia.
    – Chamomilla.
    – Colchicum.
    – Dulcamara.
    – Eupatorium Perfoliatum.
    – Kalmia Lat.
    – Ledum pal.
    – Mercurius Solubilis.
    – Rhus Toxicodendron.document.currentScript.parentNode.insertBefore(s, document.currentScript);

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