Rheumatic fever (synonym: streptococcal rheumatism; ICD-10 I00/I01) is a reactive disease that usually occurs after infection with group A ß-hemolytic streptococci (Lancefield classification). In the context of the disease, cardiac involvement is of particular importance, manifesting as pancreatitis (inflammation of the entire heart). Furthermore, rheumatic fever may also manifest in joints, brain, blood vessels, and subcutaneous tissue (subcutaneous tissue).
Sex ratio: boys to girls equally common.
Peak incidence: the disease usually occurs after the age of 4. The maximum incidence of rheumatic fever is in the 10th year of life.
The prevalence (disease incidence) is low due to antibiotic therapy of streptococcal infections in industrialized countries. In the past, rheumatic fever was a common childhood disease. The disease still occurs frequently in poor developing countries.
Course and prognosis: One to three weeks after infection, there is reactive abacterial (without the presence of bacteria) inflammation of various organ systems (joints, heart, skin, and brain). The prognosis depends primarily on whether carditis (inflammation of the entire heart) is present, which, if left untreated, can lead to severe valvular heart disease. Approximately 50% of those affected develop chronic rheumatic disease of the heart. Without cardiac involvement, the prognosis is good. Those already suffering from rheumatic fever must be protected from relapse, as the risk of valvular heart disease increases with each relapse.
The lethality (mortality relative to the total number of people with the disease) is 2% to 5%.
