Qu'est-ce que la fièvre rhumatismale ?
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**Question: What is Rheumatic Fever?**
**Answer:**
Rheumatic fever is an inflammatory condition that primarily affects the heart, joints, skin, and brain. It is a complication of untreated streptococcal throat infections (strep throat) caused by the bacteria Streptococcus pyogenes.
**Symptoms of Rheumatic Fever:**
* Joint pain and swelling, especially in the knees, ankles, elbows, and wrists
* Fever
* Muscle weakness and fatigue
* Rapid heart rate
* Chest pain and shortness of breath
* Nodules under the skin, especially over joints
* Ring-shaped rash on the chest or abdomen
**Causes of Rheumatic Fever:**
Rheumatic fever occurs when the immune system mistakenly attacks the body’s own tissues after a streptococcal infection. The exact reason for this is unknown, but it is believed to involve a cross-reactivity between the bacteria and human heart tissue.
**Risk Factors for Rheumatic Fever:**
* **History of streptococcal infections:** Untreated or poorly treated strep throat increases the risk.
* **Age:** The condition is most common in children aged 5-15 years.
* **Living conditions:** Overcrowded or unsanitary living conditions can facilitate the spread of streptococcal bacteria.
**Diagnosis of Rheumatic Fever:**
Diagnosis requires a combination of symptoms, physical examination, and laboratory tests:
* **Physical examination:** Evidence of joint swelling, heart murmur, or skin rash.
* **Blood tests:** Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels.
* **Electrocardiogram (ECG):** Abnormal heart rhythms or murmurs.
**Treatment of Rheumatic Fever:**
Treatment aims to:
* **Eliminate streptococcal infection:** Antibiotics to clear the bacteria.
* **Reduce inflammation:** Nonsteroidal anti-inflammatory drugs (NSAIDs) or salicylates to control joint pain and fever.
* **Prevent complications:** Antibiotics to prevent recurrent infections and steroids to suppress inflammation in severe cases.
**Long-Term Effects of Rheumatic Fever:**
* **Heart damage (rheumatic heart disease):** Inflammation can lead to scarring of heart valves, resulting in valve dysfunction and heart failure.
* **Chronic joint pain and arthritis**
* **Brain damage (Sydenham’s chorea):** Rare but serious neurological complication causing involuntary muscle movements.
**Prevention of Rheumatic Fever:**
* **Early and adequate treatment of streptococcal infections**
* **Good hygiene practices:** Frequent handwashing and covering coughs and sneezes.
* **Vaccination:** Regular streptococcal vaccinations are not available, but vaccines for other bacteria that cause throat infections (e.g., Haemophilus influenzae, Streptococcus pneumoniae) can help reduce the risk.
Rheumatic fever is caused by an allergic reaction to bacteria that live in the throat. The bacteria are called Group A Streptococci (GAS) and they cause strep throat. The allergic reaction to GAS can cause inflammation in the joints, heart, brain, and skin.