Complications and Systemic Medical Aspects of Rheumatic Fever

Introduction

Rheumatic fever is an inflammatory disease that primarily affects the heart, joints, skin, and nervous system. It is triggered by an immune response to untreated streptococcal throat infection. Among its systemic complications, neurological manifestations such as Sydenham's chorea are particularly notable.

Neurological Manifestations: Sydenham's Chorea

Pathophysiology of Sydenham's Chorea

Sydenham's chorea is a movement disorder that results from autoimmune reactions affecting the basal ganglia. Antistreptococcal antibodies mistakenly target neuronal tissues, leading to involuntary movements, muscle weakness, and emotional instability.

Symptoms

• Rapid, involuntary movements affecting the face, hands, and feet
• Muscle weakness
• Speech disturbances
• Emotional instability, including irritability and anxiety

Systemic Medical Aspects of Rheumatic Fever

Cardiac Complications

Rheumatic fever is a major cause of rheumatic heart disease, leading to valvular damage, myocarditis, and increased risk of heart failure.

Joint Involvement

Patients may experience migratory arthritis, predominantly affecting the knees, ankles, and wrists.

Skin and Subcutaneous Manifestations

• Erythema marginatum: A distinctive rash associated with rheumatic fever
• Subcutaneous nodules: Small, painless lumps found on bony surfaces

Treatment and Management

Management of rheumatic fever includes antibiotic therapy to eradicate streptococcal infection, anti-inflammatory medications to control inflammation, and long-term prophylaxis to prevent recurrence.