RHEUMATIC FEVER

Many years ago, rheumatic fever was one of the most common and one of the most serious diseases affecting children. A child with this condition would run a very high fever that would come and go almost every day for a period of a few weeks to a few months. In addition, there would be painful swelling with redness and tenderness of the joints, such as a knee or an ankle or an elbow or a shoulder. Sometimes the pain in the joints would be so severe that the child could not move an arm or stand on a leg. And other organs, too, like the heart, the lungs, and the kidneys, and the nerves, would be affected by the germs that caused rheumatic fever. When the rheumatic fever germs attacked the heart, the heart muscles were frequently damaged and a heart murmur would result. When the nerves were affected, the child often developed jerky, uncontrolled movements of his arms and legs and other muscles of the body that had affected nerves going to them. When rheumatic fever hit the nerves, the condition was known as Saint Vitus’ dance, because the child might look as if he were doing some sort of peculiar dance.

Rheumatic fever is caused by a particular type of streptococcus germ. Nowadays, we have extremely powerful antibiotic medicines that can kill these germs. As a result, we don’t see many children who develop rheumatic fever after a streptococcus infection. In the days before the wonderful antibiotic drugs were discovered, a child might have an attack of tonsillitis or strep throat, or would have scarlet fever, and a few weeks later, he would develop rheumatic fever. Today, a child with tonsillitis or scarlet fever or strep throat is given antibiotic medications. The germs that would have caused the rheumatic fever are killed by these medications before they can do any serious harm, and the child never gets rheumatic fever.

If a child is unlucky enough to get rheumatic fever, he must stay quietly in bed for several weeks. During that time, he will be given large doses of antibiotics to kill the streptococcus germ. He may also be given large doses of aspirin or some similar medicine to get rid of the pain and swelling in his joints. In some cases, a medicine known as cortisone is also given to control the rheumatic fever.

If a child is obedient and stays quietly in bed and takes his various medicines without too much fuss, the chances are good that no damage will occur to his heart or lungs, or to his nerves or muscles or joints.

It is thought that some cases of rheumatic fever are influenced by infected tonsils that contain a streptococcus germ. Therefore, when a child has fully recovered from an attack of rheumatic fever, the tonsils are removed. But that is not enough to prevent another attack of the disease, because the streptococcus germ may be growing in other places in the body. To prevent another attack of rheumatic fever, children are often given antibiotic medicines every day for months, or even years, at a time.

normal valve mitral atrium ventricles

The mitral valve lies between the atrium and ventricles on the left side of the heart. The normal mitral valve is strong and tightly closed.

normal valve rheumatic fever damaged mitral atrium ventricles

The mitral valve shown here has been weakened and damaged by disease. Its muscles cannot relax or contract completely. As a resuit, it has become a leaky valve that wont function normally.

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