(Fever) health education

Rheumatic Fever 

Acute rheumatic fever is a systemic disease of childhood, often recurrent that follows group A beta hemolytic streptococcal infection (GABH), usually develops within 3 weeks. It is a diffuse inflammatory disease of connective tissue, primarily involving heart, blood vessels, joints, subcutaneous tissue and CNS (Root-Bernstein, 2009). 

Autoimmune consequence of group A beta hemolytic streptococcal infection following an upper respiratory infection. Cross reactive immunity between βhemolytic streptococcal group A to human cardiac tissue (WHO, 2011). 

• Rheumatic Heart Disease is the permanent heart valve damage resulting from one or more attacks of ARF. 

• It is thought that 40-60% of patients with ARF will go on to developing RHD. 

• The commonest valves affecting are the mitral and aortic, in that order. However all four valves can be affected 

• IN Egypt, 5-7% of cardiac surgery is due to rheumatic heart complications 

• If properly treated, 75% of people with rheumatic fever recover 

Causes :

In rheumatic fever is believed to be an autoimmune disorder (in which the body’s immune system

 attacks its own tissues) induced by certain strains of streptococcal bacteria. Rheumatic fever always follows a throat infection. 

Diagnosis : 

• Rheumatic fever is mainly a clinical diagnosis  

• No specific laboratory test available for diagnosis.  

• Diagnosis based on Modified Jones Criteria for Guidance in the Diagnosis of Rheumatic Fever 

Prevention :

• The only way to prevent rheumatic fever is to treat strep throat infections or scarlet fever promptly with a full course of appropriate antibiotics

Treatment : 

• Step I  - Antibiotics  (eradication of streptococci) 

• Step II - anti-inflammatory treatment (aspirin, steroids) 

• Step III- supportive management & management of complications 

• Step IV- secondary prevention  (prevention of recurrent attacks) 

• The goals of treatment for rheumatic fever are to destroy remaining group A streptococcal bacteria, relieve symptoms, control inflammation and prevent the condition from returning. Treatments include: Antibiotics. 

• The mainstay antibiotic is IM benzathine benzylpenicillin. 

• Oral phenoxymethylpenicillin and erythromycin are also used as alternatives

Health education for fever :

• Take over-the counter and prescription medicines only as told by your health care provider. Follow the dosing instructions carefully.

• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

• General instructions

• Watch your condition for any changes. Let your health care provider know about them.

• Rest as needed.

• Drink enough fluid to keep your urine pale yellow. This helps to prevent dehydration.

• Sponge yourself or bathe with room-temperature water to help reduce your body temperature as needed. Do not use ice water.

• Do not use too many blankets or wear clothes that are too heavy.

• If your fever may be caused by an infection that spreads from person to person (is contagious), such as a cold or the flu, you should stay home from work and public gatherings for at least 24 hours after your fever is gone. Your fever should be gone without the need to use medicines.