Rheumatic Fever and Rheumatic Heart Disease

Rheumatic fever is an autoimmune disease associated with group A β-hemolytic streptococcal infection that primarily affects the heart, joints, brain, and skin. Diagnosis is made by clinical criteria along with confirmation of the presence of recent streptococcal infection. Rheumatic fever is prevalent in geographic regions that have close living quarters and poor nutrition and hygiene. Rheumatic heart disease is a common consequence of rheumatic fever and is thought to occur because of molecular mimicry between the host and the streptococcal bacteria. This reaction causes valvulitis, particularly of the mitral and aortic valves. Valve disease usually starts as regurgitation but progresses to stenosis. Acute and recurrent episodes of rheumatic fever are treatable with penicillin. Diagnosis and progression of disease and also chronic and repeat episodes of rheumatic fever can be monitored using echocardiography. Surgical intervention is sometimes required for rheumatic heart disease but typically is not necessary until adulthood.