Rheumatic fever in american children

 It is responsible for heart disease in 2 percent of American schoolchildren. Rheumatic fever is a delayed result of a streptococcal infection such as a strep sore throat, scarlet fever, tonsillitis, or middle ear infection. 

The infection may still be present when rheumatic fever strikes but more often has disappeared before the rheumatic fever becomes evident. Developed case of rheumatic fever may affect many parts of the body, the most important being the heart. The best way for a doctor to handle the threat of rheumatic fever is to treat children with strep infections promptly and effectively. Early signs of the disease usually begin 10 to 14 days after the infection and consist of fever ranging between 101° and 103°F, striking pallor, moderate weight loss, and poor appetite. 

More specific symptoms then appear. The joints are tender to the touch, they hurt when moved. Redness and swelling of the joints occur. Several joints-knees, ankles, wrists, elbows-may be involved at once succession. This severe condition is quite different from the vague, detecting muscle and tendon pains often called "growing pains." The heart may become damaged, causing a weak and rapid pulse, shortness of breath, and a puffy face. Often, blood vessels in the nose are weakened, and the nose begins to bleed. Sometimes, rashes may appear.

A special type of rheumatic fever is chorea. This most often affects children between the ages of 6 and 11, especially girls. A rash caused by the fever may appear on the body. Hard little ball-like swellings (nodules) may be seen or felt under the skin at the elbow, knee, and wrist joints, as well as along the spine. The brain is temporarily affected, causing involuntary twitching or writhing movements which make the child so clumsy he drops things and writes illegibly. Fortunately, chorea clears up and doesn't cause epilepsy or serious brain trouble. Most people with rheumatic fever do not have all the various symptoms.

At least 50 percent of people, who have chronic (long-standing) rheumatic heart disease that is discovered when they are grown, never knew they had rheumatic fever when they were children. Careful questioning by doctors sometimes reveals that at some period in the past such a person suffered from repeated nosebleeds, mild joint pains, "growing pains," or perhaps a period of months when he was not feeling up to par. The important lesson from this is to try to spot the mild cases in childhood and to take appropriate steps to prevent attacks from occurring again and again.