Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever. Strep throat and scarlet fever are caused by an infection with streptococcus bacteria.
Rheumatic fever is most common in 5- to 15-year-old children, though it can develop in younger children and adults. Although strep throat is common, rheumatic fever is rare in the United States and other developed countries. However, rheumatic fever remains common in many developing nations.
Rheumatic fever can cause permanent damage to the heart, including damaged heart valves and heart failure. Treatments can reduce damage from inflammation, lessen pain and other symptoms, and prevent the recurrence of rheumatic fever
Causes-- Rheumatic fever can occur after an infection of the throat with a bacterium called group A streptococcus. Group A streptococcus infections of the throat cause strep throat or, less commonly, scarlet fever. Group A streptococcus infections of the skin or other parts of the body rarely trigger rheumatic fever.
The link between strep infection and rheumatic fever isn't clear, but it appears that the bacterium tricks the immune system. The strep bacterium contains a protein similar to one found in certain tissues of the body. So immune system cells that would normally target the bacterium may treat the body's own tissues as if they were infectious agents — particularly tissues of the heart, joints, skin and central nervous system. This immune system reaction results in inflammation.
If your child receives prompt treatment  to eliminate strep bacteria and takes all medication as prescribed, there's little chance of developing rheumatic fever. If your child has one or more episodes of strep throat or scarlet fever that aren't treated or not treated completely, he or she might develop rheumatic fever.
Symptoms--Rheumatic fever symptoms vary. You can have few symptoms or several, and symptoms can change during the course of the disease. The onset of rheumatic fever usually occurs about two to four weeks after a strep throat infection.
Rheumatic fever signs and symptoms — which result from inflammation in the heart, joints, skin or central nervous system — can include:
·         Fever
·         Painful and tender joints — most often in the knees, ankles, elbows and wrists
·         Pain in one joint that migrates to another joint
·         Red, hot or swollen joints
·         Small, painless bumps (nodules) beneath the skin
·         Chest pain
·         Heart murmur
·         Fatigue
·         Flat or slightly raised, painless rash with a ragged edge (erythema marginatum)
·         Jerky, uncontrollable body movements (Sydenham chorea, or St. Vitus' dance) — most often in the hands, feet and face
·         Outbursts of unusual behavior, such as crying or inappropriate laughing, that accompanies Sydenham chorea
Risk factors-Factors that can increase the risk of rheumatic fever include:
Family history. Some people carry a gene or genes that might make them more likely to develop rheumatic fever.
Type of strep bacteria. Certain strains of strep bacteria are more likely to contribute to rheumatic fever than are other strains.
Complications--Inflammation caused by rheumatic fever can last a few weeks to several months. In some cases, the inflammation causes long-term complications.
Rheumatic heart disease is permanent damage to the heart caused by rheumatic fever. It usually occurs 10 to 20 years after the original illness. Problems are most common with the valve between the two left chambers of the heart (mitral valve), but the other valves can be affected. The damage can result in:
Valve stenosis. This narrowing of the valve decreases blood flow.
Valve regurgitation. This leak in the valve allows blood to flow in the wrong direction.
Damage to heart muscle. The inflammation associated with rheumatic fever can weaken the heart muscle, affecting its ability to pump.
Damage to the mitral valve, other heart valves or other heart tissues can cause problems with the heart later in life. Resulting conditions can include:
·         An irregular and chaotic beating of the upper chambers of the heart (atrial fibrillation)
·         An inability of the heart to pump enough blood to the body (heart failure)

Environmental factors. A greater risk of rheumatic fever is associated with overcrowding, poor sanitation and other conditions that can easily result in the rapid transmission or multiple exposures to strep bacteria.

Well selected Homoeopathic medicines are effective for the management of Rheumatic fever. Some important remedies are given below-
ACONITUM NAPELLS 30- Aconite is one of the excellent remedies for Rheumatic fevers. Aconite is well adapted to children ,  plethoric persons of a lively character  , who lead a sedentary life, bilious and nervous constitution. They have high color, black or brown hair. Aconite persons experiences high fevers, they have dry, hot skin, redness of the cheeks. Aconite persons have thirst during fever.  They show extreme restlessness, anxiety  and fear . There redness of the shining swelling of the affected part with shooting and tearing pain , worse at night and by touch. The throat is dry, red, constricted, numb, pricking , burning and stinging. Tonsils swollen and dry.

ANACARDIUM ORIENTALE 30- Anacardium orientale is effective for Rheumatic fever with affections of pericardium.There is rheumatic pericarditis with double stitches. Stitching pain in the heart region which may  passing in to the lumbar region. Palpitation and uneasiness in the heart.
Ancardium is best suited to persons has many mental disorders. They have bad memory and is absent minded. They have lack of confidence in himself and others. Anacardium person feels that they have two wills one commanding him to do what the other forbids. Desire to swear and curse. They are easily offended , suspicious and jealous. Profound depression with tendency to use foul, violent language.

ARNICA MONTANA 30- Arnica is another effective medicine for Rheumatic fever. Arnica is best adapted to sanguine, plethoric persons or plethoric red faced persons . It is suitable to persons who are sensitive to mechanical injuries and who feel the effects of them long after. There is soreness, numbness and swelling of the affected joint. The person have great fear of being touched or approached.Bed feels too hard. Complaints worse from movement, and damp cold weather.  Intercostal rheumatism simulates pleurisy. There is stitching pain in the heart region. Heart complaints with dilatation and dysponea. Weakened heart muscles.

ARSENICUM ALBUM 200- Arsenic alb is best for Rheumatic fever and is suited to full plethoric , nervous persons. The person shows both mental and physical restlessness. He changes place continually. There is great anxiety, fear of death and disease and have great prostration. There is rapid onset of high fever. The patient have pain in  knee joint that kept him turning and twisting, though every movement provoked cries and both elbows were quickly worn through the efforts to turn. The mouth and tongue were dry on waking, and there were night sweats. The patient is thirsty , thirst for small quantities of water at short intervals. The throat swollen, edematous, constricted and unable to swallow anything. The diphtheric membrane looks, dry and wrinkled. All complaints are worse at midnight, from 1-2 am.
Heart pains into neck and occiput with anxiety, difficult breathing and fainting spells. There is palpitation with dyspnoea and weakness.

AURUM METALLICUM 30-Aurummet is suited to sanguine people with black hair and dark eyes and olive brown complexion. There is febrile chills all over the body , while in bed in the evening. There is nightly leg pains. There is valvular lesions of heart. Heart feels loose on walking. Sensation as if heart stopped beating for two or three seconds , immediately followed by tumultuous rebound with sinking at the epidastrium. Violent palpitation compels him stop.

BELLADONNA  30-Belladonna is suited to plethoric persons with red face and to conditions where there is local plethora. It is also suited to bilious and lymphatic temperament. They have light hair and complexion, blue eyes. During fever the joint becomes red, hot and shining. Very sensitive to touch or jar. Red streaks radiate from the inflamed joint. There is recurrent fever with pains attacking nape of neck.The throat feels dry, as if glazed. Great congestion- angry looking congestion. The inflamed red colour more on right side. Tonsils enlarged and congested. The throat feels constricted , swallowing difficult, especially liquids.There is a sensation of lump and scraping in throat.
Heart seemed too large. Palpitation from least exertion. Bubbling at the region of the heart.

BRYONIA ALBA 30- Bryonia affects the constitution of a robust, firm  fiber and dark complexion with tendency to leanness and irritability. It is suited to gastro- bilious –rheumatic constitutions. Bryonia is adapted to nervous, dry slender people. During the fever the joint becomes red, shinning, swelling and rigid. There is shooting, tearing pain or tensive pains or shifting pains which affects the muscles rather than bones. Pain worse at night and from least movement. There is great thirst for water.There is much heat and profuse perspiration and coldness and shivering. Fever with headache and derangement of stomach. The throat is dry, sticking on swallowing, scraped and constricted.
Bryonia persons have stitching pain in the cardiac region.

CACATUS GRANDIFLORUS 3X—Cactus is best suited to sanguine constitutions. It is excellent for inflammatory rheumatism with heart complaints. The main symptom is a feeling of constriction everywhere. There is constriction of heart , as if an iron band prevented its normal movement or as if caged. The tongue is dry as if burnt, needs much liquid to get food down. There is suffocative constriction in throat. Rheumatic pains in shoulders, upper and lower arms, in hips, down to feet, worse in rest and in motion and in all positions.

DROSERA ROTUNDIFOLIA  30-Drosera is suited to tubercular constitutions. Fever with internal chilliness , shivering, with hot face and cold hands. There is no thirst. The bed feels too hard. Shivering when rest, on moving  no shivering. Febrile rigor all over the body. There is gnawing and shooting pain in the shafts of the long bones , arms, thighs, and legs. Severe stitching pain in joints, especially ankle joint. Pain as if dislocated and with great stiffness.

EUPATORIUM PERFORATUM 30- Eupatorium suited to worn out constitutions  from inebriety. There is high temperature and chills. Chill preceded by thirst with great soreness and aching of bones. There is much shivering. The patient feels that the bones bruised, broken and dislocated. Rheumatism with perspiration nad soreness of bones.Joints mainly affected are hip, shoulder, inside knee, foot, great toe, and elbow.  There is sharp pain in hip, ankle and shoulder joints, worse from 10 a.m .to 4 p.m.The patient wants to keep still, but must move.There is pressure in heart region as if the heart is too small a space.There is pain, soreness and heaviness behind sternum and cardiac region  worse by least motion and turning the body around.

FERRUM PHOS 30-- Ferrum phos is suite to leucoplegmatic temperament young persons and nervous, sensitive anemic persons. There is high fever with acute articular rheumatism. Rheumatism affecting one joint after another, joints puffy but little red. Red, swollen and very sensitive joints, worse from least movement. The throat, mouth, fauces became red, hot and inflamed. Throat sore and ulcerated. Tonsils red and swollen. The person feels  severe palpitations.

GELSEMIUM 200- Gelsemium is suited to persons of a nervous and hysterical temperament. Fever with great prostration and headache. Fever with chills up and down the back. Heat and sweat stage long lasting. There is no thirst. The patient wants to be held because he shakes so. There is a feeling as if it were necessary to keep in motion or else hearts action would cease. Pulse, slow, full, soft, and compressible .

KALMIA LATIFOLIA 30-Kalmia is best for Rheumatic fever with migratory rheumatism with heart complaints. Kalmia is best for protracted and continues fevers with tympanites. Here the rheumatic pain extend downwards and shift suddenly. Pain affect a large part of the limb or several joints and pass through quickly. Joints red, hot and swollen. There is tingling and numbness of left arm with heart complaints. There is sharp pain in the heart region which is burning, shooting, or stabbing radiating to the left arm. Violent palpitation is another leading symptom, which is worse learning forward.

NUX VOMICA 30-Nux vomica is suited to zealous persons inclined to get angry and excited or of a spiteful , malicious disposition. During fever here the whole body burning hot, especially face red and hot, yet cannot move or uncover in the least without feeling chilly.Fever with vertigo , chilliness alternating with heat, pain in head, back and limbs. There is swelling of large joints with tensive swelling. The pain get worse from motion, least jar, and cold. Better from warmth, getting warm, hot things. Heart feels tired and palpitation on lying down. During heart pain the patient lies on knee with body learnt backwards.

RHUS TOXICODENDRON 200- Rhus tox is another excellent remedy for Rheumatic fever. Rhus tox is suited to rheumatic constitutions. It is adapted to psoric and tubercular constitutions. During fever there is great restlessness. Shivering and shaking in open air with thirst. There is soreness and stiffness of joints. Pain in chest , worse by using arms in making a bed.There is drawing tearing pain in limbs during rest, better from motion.The affected joints are red, swell, having much shining with rigidity or shooting when touched. Pain worse from rest or in cold, damp weather.Heart  feels tired , pains go down left arm. There is trembling and palpitation when sitting still.

SALICYLIC ACID 30- Salicylic acid is best for Rheumatic fever with inflammatory rheumatism of one or more joints, especially elbows or knees along with fever. There is high fever with swelling and redness of joints. Movements very difficult and sensitive to least jar.

SPIGELIA 30-Spigelia is excellent for Rheumatic fever with heart complaints. Spigelia is best adapted to anemic, debilitated, rheumatic and scrofulous persons. There is high fever with chilliness on least motion. Sore throat with lancinations and swelling in palate.There is drawing , tearing twitching pain in limbs and joints. Rheumatic carditis with trembling pulse. There is violent palpitation which is audible.

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