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Rheumatic Fever

What are called "growing pains" may be the signal of rheumatic fever.

What are called “growing pains” may be the signal of rheumatic fever.

Rheumatic fever of inflammatory rheumatism is a very serious disease that mainly affects children and young people in their teens. It is thought to be an allergic condition that attacks the connective tissue of the body, causing joint paints – St. Vitus’ dance – due to central nervous irritation and skin lesions. All these are more or less temporary. The really serious part of this disease is the danger does to the valve of the heart. Certain strepoccus germs presents in the throat are apparently responsible. The body becomes highly sensitized to their presence, and it is this allergic response that does the damage.

In most cases the child first develops a sore throat. Several days or weeks later he may have a fever with aching in the joints, a lack of appetite, profuse sweating, and perhaps even a rash. No tow cases are exactly alike in their manifestations. This often makes the diagnosis difficult and uncertain. If there is any doubt, it is best to carry out the treatment as outlined here.

Rheumatic fever seems to run in certain families. If both parents have had the disease during childhood, their children are more likely to have rheumatic fever. Wherever large numbers of children and young people are gathered together there is always the likelihood of rheumatic fever of inflammatory rheumatism. Overcrowding, malnutrition, and dampness always play a part. Small outbreaks of rheumatic fever may occur in army barracks.

Although rheumatic fever attacks the whole body, the greatest damage occurs in the heart. Two of every hundred children in school are likely to have some form of rheumatic heart disease. Rheumatic fever cause more deaths during the first twenty years of life than all other infectious disease added together. These are facts no parent can afford to forget. Rheumatic fever strikes children in every part of the world.

Course of the Disease:

Rheumatic fever usually strikes first in childhood, around eight years of age. The child comes down with a sore throat or cold, followed by an attack of tonsillitis or perhaps scarlet fever. While he is recovering from the infection, one or two of his larger joints become red, swollen, and tender to the touch. There is also soreness in the muscle and tendons, as well as lack of appetite and a feeling of weakness. Tender nodules may appear on the skin, particularly over certain joints, such as the elbows.  Nose bleeding is common in rheumatic fever, even when there has been no injury.

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Pains in the chest probably mean that the inflammation has reached the pericardium and heart muscle itself. The child may develop pneumonia, pleurisy, and even abdominal pain resembling acute appendicitis. The patient may become fidgety due to Sydenham’s chorea, or St. Vitus’ dance. This is more common in girls but also occurs in boys at times. Hand movements may be rapid, jerky, and irregular, and the patient has a tendendy to drop things. There maybe weakness in the muscle and even some difficulty in chewing and swallowing, particularly in younger girls.

Not all cases of rheumatic fever are this definite. In some children the disease maybe a low grade, smoldering type with few difinite signs. But the child is not well. He is easily fatigued and may not gain weight as he should. He may have a persistently rapid pulse rate and a low grade of fever, continuing for long periods of time. The child may complain of “growing pains.”  This means an aching pain in the muscles and joints, and perhaps over the heart. Such complaints must be taken seriously. The child should be put to bed and kept there ill he is well and strong again. School is far less important than his future health.

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  1. [...] heartbeat is more serious when there is some inflammation of the heart muscle itself, such as in rheumatic fever or coronary [...]

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