Rheumatic Fever - Experience

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What is rheumatic fever?

Rheumatic fever (acute rheumatic fever or ARF) is an autoimmune disease that may occur after a group A streptococcal throat infection that causes inflammatory lesions in connective tissue, especially that of the heart, joints, blood vessels, and subcutaneous tissue. The disease has been described since the 1500s, but the association between a throat infection and rheumatic fever symptom development was not described until the 1880s. It was associated with scarlet fever (rash caused by streptococcal exotoxins) in the 1900s. Prior to the broad availability of penicillin, rheumatic fever was a leading cause of death in children and one of the leading causes of acquired heart disease in adults. The disease has many symptoms and can affect different parts of the body, including the heart, joints, skin, and brain. There is no simple diagnostic test for rheumatic fever, so the American Heart Association's modified Jones criteria (first published in 1944 and listed below) are used to assist the physician in making the proper diagnosis.

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Comment from: Dfreezy1907, 55-64 Female (Patient) Published: May 20

It all began in late April 2013 when a painful cyst emerged overnight on the surface of my index finger at the first joint. I couldn't bend it and it was painful to the touch. I recall a small lump under the skin the previous week. It scared me enough to go to the doctor the next day. He said he'd never seen a cyst in that location, called it a bacterial infection and prescribed Bactrim. Two days later, I woke up at 2 a.m. with pain on the top of both knees. I applied ice and managed to get back to sleep. The next morning the pain had subsided in my right knee, but the left one was still sore. I went about my activities, thinking perhaps it was the weather. The following day it got worse more swollen and I couldn't bend it. The next day, I could hardly walk and developed a low fever. I went to the ER at 7 p.m.; where they ran blood and urine tests, but said results wouldn't be conclusive because I was already on antibiotics. Later, the doctor called to tell me I might have infectious endocarditis because I had been to the dentist recently. My doctor ordered an X-ray and blood cultures and sent me to a cardiologist the same day. There, I received an EKG and ultrasound of the heart. More blood and urine was taken and Augmentin was prescribed. The next day I went back to my PCP with knee pain, which had spread to behind the knee and was also in my left wrist and right elbow. They also noticed a rash on my arms and chest, and told me to stop the Bactrim, thinking it might be an allergic reaction. A few days later at my cardiologist appointment, I was told I had a high level of strep in my bloodstream along with a low white blood cell count and decreased kidney function. Because of all the other symptoms, he called it rheumatic fever. He said it is rare in adults, but that the good news is that it hasn't affected my heart valves. I am recuperating with low energy.

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Comment from: Raye, 55-64 Female (Patient) Published: October 15

I was 4 when I first got rheumatic fever. I lay on a stretcher in my parents' room for months, unable to walk or move. At times I had to be turned over. I suffered three times up to the age of 12 and I had glandular fever a few times as well. Each time I couldn't walk and the last time I had to learn to walk again. I was hospitalized for a lot of those years. The doctor put me on long term antibiotic penicillin until I ended up with urticaria and stopped (swelling of my whole body and a rash). I was told that I had a heart murmur. Currently I am about to have an echo heart test as I am always tired. I have developed an extremely painful thumb and triggering in both thumbs. I am yet to have blood tests for the hand pain. I get swollen ankles.

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