Rheumatic fever

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Causes

By Mayo Clinic staff

Rheumatic fever can occur after an infection of the throat with a bacterium called Streptococcus pyogenes, or group A streptococcus. Group A streptococcus infections of the throat cause strep throat or, less commonly, scarlet fever. Group A streptococcus infections of the skin or other parts of the body rarely trigger rheumatic fever.

The exact link between strep infection and rheumatic fever isn't clear, but it appears that the bacterium "plays tricks" on the immune system. The strep bacterium contains a protein similar to one found in certain tissues of the body. Therefore, immune system cells that would normally target the bacterium may treat the body's own tissues as if they were infectious agents — particularly tissues of the heart, joints, skin and central nervous system. This immune system reaction results in inflammation.

If your child receives prompt and complete treatment with an antibiotic to eliminate strep bacteria — in other words, taking all doses of the medication as prescribed — there's little to no chance of developing rheumatic fever. If your child has one or more episodes of strep throat or scarlet fever that aren't treated or not treated completely, he or she may — but won't necessarily — develop rheumatic fever.

References
  1. Rheumatic fever. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec19/ch281/ch281a.html. Accessed Dec. 3, 2008.
  2. Carapetis JR, et al. Acute rheumatic fever. Lancet. 2005;366:155-168.
  3. Gibofsky A, et al. Epidemiology and pathogenesis of acute rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Dec. 4, 2008.
  4. Gibofsky A, et al. Clinical manifestations and diagnosis of acute rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Dec. 4, 2008.
  5. Hahn RG, et al. Evaluation of poststreptococcal illness. American Family Physician. 2005;71:1949-1954.
  6. Strep throat: Symptoms. National Institute of Allergy and Infectious Diseases. http://www3.niaid.nih.gov/topics/strepThroat/symptoms.htm. Accessed Dec. 15, 2008.
  7. Parenting corner Q&A: Sore throat. American Academy of Pediatrics. http://www.aap.org/publiced/BK0_SoreThroat.htm. Accessed Dec. 15, 2008.
  8. When your infant or child has a fever. American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/children/parents/common/common/069.html. Accessed Dec. 15, 2008.
  9. Gerber M. Streptococcus pyogenes (Group A streptococcus). In: Long S, et al., eds. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa.: Churchill Livingstone/Elsevier; 2008. http://www.mdconsult.com/das/book/body/113823919-10/783584111/1679/122.html#4-u1.0-B978-0-443-06687-0..50121-1--cesec21_2521. Accessed Dec. 15, 2008.
  10. Weinberg G. Rheumatic fever. The Merck Manuals Online Medical Library: Home Edition for Patients and Caregivers. http://www.merck.com/mmhe/sec23/ch272/ch272h.html. Accessed Dec. 3, 2008.
  11. Gibofsky A, et al. Treatment and prevention of acute rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Dec. 4, 2008.

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Jan. 23, 2009

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