A child ora young adult complains of acute pain and often swelling in several joints. As the inflammation subsides in these joints, other joints get affected. The patient has high temperature and there may be cardiac involvement- endocarditis. The condition is Acute Rheumatism or Acute Rheumatic Fever.

There is usually a history of tonsillitis due to haemolytica streptococcus infection, a week  or two previous to the present complaint. The attack of acute rheumatism comes on with fever and joint pains appear within twenty four hours. The usual accompaniments of fever are present. Joint pains are acutely painful on least movement; affected joints are warm and tender to touch, and are more likely to show effusion in adults. Cardiac involvement is the most important and least amenable to treatment, this is when permanent damage sets in. in children, mitral endocarditis sets in.

SYMPTOMS OF ACUTE RHEUMATISM or ACUTE RHEUMATIC FEVER

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 beneath the skin
• Chest pain
• Heart murmur
• Fatigue
• Flat or slightly raised, painless rash with a ragged edge
• Jerky, uncontrollable body movements (Sydenham chorea) — most often in the hands, feet and face
• Outbursts of unusual behavior, such as crying or inappropriate laughing, that accompanies Sydenham chorea

CAUSES OF ACUTE RHEUMATIC FEVER

Rheumatic fever can occur after a throat infection from a bacteria 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 bacteria trick the immune system.

The strep bacteria contain a protein similar to one found in certain tissues of the body. The body's immune system, which normally targets infection-causing bacteria, attacks its own tissue, particularly tissues of the heart, joints, skin and central nervous system. This immune system reaction results in swelling of the tissues (inflammation).

RISK FACTOR OF ACUTE RHEUMATIC FEVER

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.
• 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.

COMPLICATION OF ACUTE RHEUMATIC FEVER

Inflammation caused by rheumatic fever can last a few weeks to several months. In some cases, the inflammation causes long-term complications.

Rheumatic fever can cause permanent damage to the heart (rheumatic heart disease). It usually occurs 10 to 20 years after the original illness, but severe cases of rheumatic fever can cause damage to the heart valves while your child still has symptoms. 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:

• Narrowing of the valve. This decreases blood flow.
• Leak in the valve. A leaky valve causes 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 heartbeat (atrial fibrillation)
• Heart failure

HOMOEOPATHIC TREATMENT OF ACUTE RHEUMATIC FEVER

Aconitum napellus, belladonna, Bryonia alba, arsenicum album and rhus toxicodendron are those remedies which are normally indicated at the onset of fever. If prescribed in time, chances are that the condition can be aborted. After the acute phase of temperature is over, pains are experienced by the patient in the limbs and joints.

Colchicum Autumnale :  markedly affects, fibrous tissues, serous membrance and small joints, with stitching pain in the muscles, periosteum and joints. These shift rapidly and the swellings are very minimal. Pains are worse by mental exertion, emotions, slightest touch and vibrations. Heart disease with rheumatism; peri carditis appears when symptoms of limbs disappear. There is anxiety in the region of the heart and oppression, better by walking.

Kalmia Latifolia has a prominent action upon the heart. It is a heart circulation, nerve and rheumatic remedy. The pains are neuralgic, shooting downwards with tingling, numbness, trembling and paralytic weakness. Pains along the ulnar nerve go into the third or fourth finger. The joints are red, hot, swollen; tingling and numbness of the left arm indicating cardiac involvement. Neuralgia of the right side; wandering, rheumatic pains; pains shift rapidly; accompanied by tumultuous action of the heart and a slow pulse.

Ruta Graveolens has an affinity for fibrous tissues, flexor tendons, joints, cartilages and periosteum. Rheumatism- pains are sore, aching, in the periosteum. Cracking in joints; knees give away while ascending or descending stairs. Pain, as if deep in the bones. Acute rheumatism after over use or straining joints, ligaments or tendons.

RL-35 - Joint Pain, Muscle Pain and Nerve Pain