Acute Rheumatic Fever Blues

Let’s make sure I get this right, Rheumatic fever is an inflammatory disease that usually develops approximately 20 days after a streptococcus bacterial infection. It is common world wide, but quite rare in The United States. The illness primarily affects children ages 5-16, 20 days following a streptococcal infection such as strep throat or scarlet fever. Females are much more prone to Acute Rheumatic Fever than Males. Symptoms include but are not limited to fever, joint-pain, joint swelling, Epistaxis, asymptomatic cardiac involvement, erythema marginatum, emotional instability (like I need any more of that and muscle weakness and fatigue. There is no one single blood test that can allow a physician to make a diagnosis of Acute Rheumatic Fever, but blood tests for recurrent strep infections (ASO or antiDNAse B), presence of symptoms and monitoring of levels of antistreptylosin, which is an antibody that is related directly to rheumatic symptoms. When you have an infection your white blood cells and specific antibodies become elevated as your body fights off the infection. A normal ASO level is 0-200; mine has come down and is now 484.7. I have been on anti-biotics for a week and still maintain a fever. Long-term heart valve damage is common with people who are untreated or have the illness for long periods of time. As well as Endocarditis, Heart Failure, Arrhythmias and Pericarditis. I get my echocardiogram on Thursday, which just thrills me with my family history of heart disease. Treatment consist of a long period of treatment with anti-biotics, usually erythromycin, penicillin or sulfadiazine. I’m allergic to the last two so I am on the first. Treatment also includes anti-inflammatories and corticosteroids. All of which I am on and best I can tell I’m not getting any better at all. So maybe you’re wondering how in the hell did a 30-year-old male get a disease that is most commonly found in female’s ages 6-15? Well if you were wondering, you’re not alone; I’ve been pondering that one too. This is a very old illness, it was extremely common and often deadly in the first part of the 20th century in America, particularly during the depression, in which overall living conditions and quality medical treatment was not readily available to the average Joe on the street. One more curveball for you. If you haven’t already read about it or don’t know I have a severe mental illness: schizoaffective mood disorder, the ICD9 Code is 295.7 if you are interested in looking it up. Ok no big deal I have been on psych meds for 20 years and I’m stable. Wrong, those corticosteroids seem to enjoy triggering long term intense manic episodes for me. It’ll keep me awake so long and going so fast and have my thoughts so disorganized that I might actually believe I am a 6-15 year old female.


National Institute of Health
http://www.nlm.nih.gov/medlineplus/ency/article/003940.htm