Why is a nasopharyngeal infection dangerous in a child? An experienced pediatrician tells about the symptoms of rheumatism in children. Rheumatism in children: manifestations and child care Rheumatic heart disease in children symptoms and treatment

Many parents are familiar with the situation when a child complains that his legs hurt, and at the same time looks tired and broken. Usually, adults attribute this condition to the excessive activity of the baby during the day. However, if such a situation repeats itself quite often, one should take a closer look at the health of the child: the described manifestations may indicate the development of such a serious disease as rheumatism.

Rheumatism in children is quite common. Moreover, babies under one year old do not get sick, but children from 1 to 5 years old are already susceptible to this pathology. The peak incidence of childhood rheumatism occurs at the age of 10-15 years. It should be understood that rheumatism is a serious disease that, in the absence of timely and competent treatment, can lead to serious complications (heart failure, heart defects, etc.). Consider the causes, signs, and methods of treating rheumatism in children.

Causes of rheumatism

Rheumatism is an infectious-allergic disease in which a systemic lesion of the connective tissue occurs. The versatility of the symptoms of this disease is due to the fact that the pathological process develops directly in the connective tissue, and it is present throughout the human body.

Rheumatism in children in most cases occurs after a streptococcal infectious disease that has not been treated with antibacterial drugs. The causative agent of the disease - hemolytic streptococcus - is the cause of acute respiratory infections, tonsillitis and scarlet fever. However, for the development of rheumatism, the mere presence of a pathogen in the child's body is not enough. The disease occurs only in those children who have been ill and who have had a malfunction in the functioning of the immune system. As a result of such a violation, antibodies are produced that attack the own cells of the connective tissue, which leads to its defeat.

Factors that provoke the development of rheumatism in children, experts call the following diseases and conditions:

• Chronic foci of infection in the body, in particular sinusitis, tonsillitis, otitis media, caries;
• hypothermia;
• Overwork;
• An unbalanced diet in which the child does not receive the required amount of proteins and vitamins;
• hereditary predisposition;
• Congenital infection with streptococcus.

Symptoms of rheumatism in children

The manifestations of rheumatism in children depend on its phase and form. The inactive phase of the disease is characterized by the absence of symptoms. The baby's well-being remains normal, only after a physically active or emotionally intense day can he complain of fatigue, pain in the legs or arms.

Symptoms of the disease in the active phase differ depending on its form: articular, cardiac or nervous.

In the articular form, a common symptom of rheumatism in children is severe pain in swollen joints against the background of an increase in body temperature. As a result, movement becomes difficult. Large joints are predominantly affected, in particular the ankle, knee, elbow, wrist, shoulder. Sometimes this form of rheumatism is not so acute: there is no fever and swelling, and the child complains of pain in one or the other joint.

The cardiac form of the disease can begin acutely (high body temperature, deterioration of health) or develop gradually. The kid gets tired quickly, he has weakness, and with the slightest physical exertion, the pulse and heartbeat quicken. If the heart is severely damaged, the child may develop pericarditis (inflammation of the pericardium of the heart).

In the nervous form of rheumatism in children, involuntary twitches of the muscles of the legs, arms, eyes and face are observed, which resemble grimacing. Such movements are intensified when the child is in an excited state. Sick children become irritable and whiny; schoolchildren usually worsen handwriting.

More rare symptoms of rheumatism in children, doctors call rheumatic pneumonia, nephritis, hepatitis, skin lesions (rheumatic nodules), etc.

Treatment of rheumatism

Treatment of rheumatism in children should be carried out in three stages: inpatient, sanitary-resort and dispensary.

Inpatient treatment usually lasts 1.5 months and the first 1-2 weeks require strict bed rest. Complex therapy consists of drug treatment, physiotherapy methods and physiotherapy exercises. Antibiotics, NSAIDs, antihistamines, and immunosuppressants are commonly prescribed as medications. If necessary, the doctor may prescribe heart and diuretic drugs, as well as other medicines, to a small patient.

Sanitary-resort treatment of rheumatism in children reinforces the results of the above therapy. At this stage, special attention is paid to physiotherapy, therapeutic exercises, vitamin therapy and good nutrition.

The purpose of dispensary observation of children is the timely detection of activation of rheumatism and its prevention.

Prevention of rheumatism in children

Specialists distinguish between primary and secondary prevention of rheumatism in children. The primary is to prevent the child from developing this disease. The main thing is to timely treat infectious diseases of streptococcal origin, not only in the baby, but also in all family members. It is important to prevent the development of chronic foci of infection in the body, especially in the nasopharynx and oral cavity. The hardening of a child from an early age, the correct daily routine and a balanced diet are also relevant. 5 out of 5 (2 votes)

acute rheumatic fever

Rheumatism is an autoimmune disease that affects connective tissue. The etiology, that is, the reliable cause of this pathology, is inflammation of the tonsils caused by group A beta-hemolytic streptococcus. The disease manifests itself with a whole range of symptoms: arthritis, damage to the heart, skin, and nervous system. Complications from the heart can be especially severe, the formation of its defects leads to disability and a deterioration in the quality of life. Therefore, it is important for parents to know the main symptoms of rheumatism in children and methods of its treatment.

Before the introduction of antibiotic therapy into medical practice, childhood rheumatism was a fairly common complication after a streptococcal infection. However, at present, the incidence has dropped sharply, especially in regions with a good level of medical care. However, the incidence of rheumatism is still high in countries with warm climates and poor medical quality.

Causes of the disease

Why rheumatism develops in some people after a sore throat, while in others it passes without a trace, it has not yet been fully clarified. There is an assumption about the role of some genetic factors that create prerequisites for the development of the disease.

In addition, provoking factors can be:

• poor social conditions;
• insufficient hygiene;
• lack of qualified medical care;
• disorders in the immune status.

How does it develop

Rheumatism is an autoimmune disease that is caused by a specific bacterium - beta-hemolytic streptococcus A. When the pathogen enters the body, the immune system produces antibodies that bind to receptors on the surface of the microbe and make it recognizable to the immune system. Thus, the child's body neutralizes the pathogen.

For some time, even after the symptoms of the disease have disappeared, antibodies still circulate in the blood of an ill child. If re-infection occurs, they quickly and effectively neutralize the pathogen, that is, immunity is formed.

However, in some cases, it happens that the antibodies cannot correctly determine the source of danger and bind to the receptors of the child's own cells. This is what happens in the case of rheumatism, when the immune system attacks the cells of the joints, the skin, or the surface of the heart valves. This phenomenon is called an autoimmune reaction, that is, the reaction of the body against itself.

In the case of infection with beta-hemolytic streptococcus, autoimmune processes occur much more often than when exposed to other pathogens. This is due to the similarity of receptors on the surface of streptococcus and human cells, as a result of which antibodies "confuse" them ("molecular mimicry").

What to look out for

Since the cause of rheumatism is the lack of adequate antibiotic treatment of streptococcal tonsillitis or tonsillitis, parents should be especially careful if the child has the following symptoms:

• sore throat;
• temperature rise;
• headache, weakness;
• redness of the pharynx, tonsils with purulent plugs;
• enlarged cervical or submandibular lymph nodes.

flow options

To date, a classification has been developed depending on the activity of inflammatory changes, the nature of the course, the presence of complications of the disease. So, downstream rheumatism can be:

• sharp;
• subacute;
• protracted;
• recurrent;
• latent.

Symptoms of rheumatism in children

Rheumatism in a child is a whole complex of characteristic symptoms. They can have varying degrees of severity and be combined individually for each patient.

After the acute inflammatory process subsides in the nasopharynx, a period of relative well-being begins, which lasts from two to three weeks. After this, acute rheumatic fever develops, in children it is characterized by the following symptoms:

• joint pain, redness of the skin and swelling above them;
• cardiological pathology (endocarditis, myocarditis, pericarditis);
• damage to the nervous system (chorea);
• skin signs;
• temperature rise.

Symptoms of rheumatism in children can be mild and in some cases ignored by parents. There may also be no pain in large joints with reddening of the skin over them. Or, on the contrary, severe pain is accompanied by the absence of swelling and redness to the child. In this case, the lack of antibiotic therapy will become a provoking factor for the further progression of the pathological process.

Polyarthritis

Manifested by "flying" pain in the joints, which disappears in a few days, quickly passing reddening of the skin over them and swelling of the joints. As a rule, several large joints (hip, elbow, knee) are affected in a child, and the inflammatory process “migrates” from joint to joint.

These phenomena are considered harmless, as they rarely lead to serious consequences or complications from the musculoskeletal system.

Heart failure

This is the most serious and dangerous sign of rheumatism for a child. In this case, the disease can be suspected:

• increased heart rate;
• the appearance of pain in the heart, even with minor physical exertion.

The defeat of the heart is confirmed during the examination of the pediatrician during auscultation (listening to heart sounds).

Less commonly, children develop pericarditis or myocarditis. In the latter case, the process can lead to a weakening of the pumping function of the heart and the development of heart failure, which is manifested by shortness of breath, cough, and swelling in the legs.

Chorea

When immune cells attack the nervous system, the child develops Sydenham's chorea. It is characterized by damage to the deep structures of the brain and manifests itself:

• behavioral disorders;
• involuntary muscle twitches.

In young children, it is manifested by uncontrolled and unstable movements, which outwardly looks like awkwardness when performing habitual actions. For example, a child who was previously tidy may spill soup or inadvertently break a toy.

In schoolchildren, early signs of chorea include the onset of trembling, which causes difficulty in writing, problems in performing stereotyped movements and maintaining personal hygiene. They can occur at certain times during the day and disappear during sleep or stress.

In addition, children with chorea are characterized by constant fatigue and personality changes, capriciousness, groundless resentment. Schoolchildren's performance falls, there are problems with concentration.

Typically, such neurological disorders, in contrast to cardiac lesions, have a favorable prognosis. Sydenham's chorea with adequate treatment disappears after a few months.

Skin manifestations

These are less common signs of rheumatism in children and often look like patches of ring-shaped redness or small subcutaneous lumps (nodules). In the latter case, the skin over such formations is not changed, they are painless and dense to the touch. Often they are on the elbows, wrists, knees and Achilles tendon.

Skin manifestations occur in less than five percent of cases of rheumatism in children. Often they are ignored or not detected, especially if they are located in hard-to-reach places.

Long-term consequences

More distant symptoms appear years or decades after the onset of the disease. In this case, they are already caused by structural and irreversible changes in the tissues. As a rule, complications appear at an older age and are the result of disorders that arose in childhood.

Most often, children are concerned about complaints from the cardiovascular system. Cardiological pathology persists throughout life and requires a certain therapeutic correction. These babies may be diagnosed with:

• mitral valve prolapse;
• aortic valve disease;
• myocardiosclerosis.

With a significant severity of the process, these changes lead to the development of heart failure, cardiac arrhythmias. This becomes the cause of disability of the child and even death.

How is pathology diagnosed?

The presence of joint pain in a child and fever, especially if a sore throat is mentioned in the anamnesis a few weeks ago, should always prompt the doctor to think about the development of rheumatism. To make a clinical diagnosis, the criteria developed by Johnson back in 1944 are used:

• arthritis;
• carditis;
• rheumatic nodules;
• skin rashes;
• chorea.

However, given the clinical diversity of the variants of the disease, it is not always possible to make a correct diagnosis during the initial examination. In this case, additional examination methods are recommended:

• general clinical blood test;
• rapid test for detection of streptococcal infection;
• determination of antistreptolysin titer;
• titers of anti-DNase B.

Ultrasound and electrocardiography (ECG) are additionally used to assess possible damage to the heart.

What states should be distinguished from

Differential diagnosis of rheumatism is carried out with other diseases that have similar symptoms:

• arthritis of other etiology;
• Lyme disease (an infectious disease transmitted by a tick);
• blood diseases (leukemia);
• congenital heart defects;
• cardiological pathology of a non-rheumatic nature.

Post-streptococcal arthritis

This condition is distinguished into a separate form from rheumatism due to clinical differences. It takes a long time, usually not less than two months. Usually one or more large joints (knee, elbow, ankle, shoulder) are affected. The disease can recur several times during life.

Joint damage is manifested by pain, redness and swelling. Sufficiently strong pain sensations sometimes lead to impaired movement in the limb and restriction of movement.

How is it treated in the acute period

Treatment of rheumatism in children in the acute period involves the presence of the child in a specialized hospital. At this stage, pharmacotherapy is carried out, aimed at eliminating the inflammatory process. Drug therapy for rheumatism includes several groups of drugs.

• Antibiotics. According to existing clinical guidelines, they are the main element in the treatment of rheumatism. For pharmacotherapy, drugs of the penicillin series ("Penicillin", "Amoxicillin") are used, cephalosporins ("Cefuroxime") and macrolides ("Azithromycin") are also recognized as effective. The use of antibiotic therapy can reduce the risk of complications by 80%.
• Anti-inflammatory. These are non-steroidal (non-hormonal) drugs. They are included in the treatment regimen in the presence of cardiac pathology. Prescribe medications such as Ibuprofen or Naproxen.
• Glucocorticoids. Assign additionally for severe violations of the function of the heart. The most commonly used is Prednisolone.

At this stage of therapy, the nursing process includes quality care for a patient who is on half-bed rest. A diet with sufficient intake of protein, vitamins and trace elements is recommended.

Therapy during remission

At the stage of rehabilitation, which is carried out at home or in sanatoriums, exercise therapy, massage, sanitation of foci of chronic infection are recommended. In the case of the formation of heart valve disease with severe functional insufficiency, surgical intervention is recommended. It can be carried out no earlier than one year after the elimination of the acute phase of the disease.

Children who have had a rheumatic attack, especially if heart damage has been diagnosed, will need dispensary observation with a pediatric cardiologist and prophylactic anti-relapse therapy. In this case, the so-called secondary prevention of rheumatism in children is carried out. It includes the following points:

• the introduction once every three to four weeks of prolonged penicillin;
• examination by a cardiologist twice a year;
• twice a year course intake of non-steroidal anti-inflammatory drugs.

The duration of such prophylaxis is determined by the presence or absence of heart damage. In the presence of cardiac pathology, it is recommended until the age of 21, in the absence of - within five years.

Prevention

The basis of prevention is the timely detection of streptococcal infection in a child with a sore throat and fever. In this case, a doctor's examination and research to identify streptococcus is mandatory. In addition, primary prevention of rheumatism includes:

• treatment of chronic diseases of the nasopharynx;
• hardening, vitamins and other recreational activities;
• compliance with the regime of work and rest, especially among schoolchildren.

These activities are especially necessary for children with a hereditary predisposition, in whose family there are already patients with rheumatism.

Treatment of rheumatism in a child is a rather complicated process. However, the use of modern antibacterial drugs significantly increases the chances of recovery. The prognosis for rheumatism largely depends on how timely it was diagnosed and therapeutic measures were started. If therapy was carried out at the initial stage of the process and in the absence of cardiac pathology, then the prognosis for the child is favorable in most cases.

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Rheumatism is a systemic inflammatory disease of the connective tissue with possible damage to the heart. This disease affects not only adults. Rheumatism in children is also common. More than two-thirds of cases are observed in children from ten to fifteen years old, about twenty percent of cases from one to five years old, in younger children rheumatism occurs very rarely.

The concept of rheumatism includes three forms of the disease - articular, cardiac and nervous. Each of them has its own characteristics and, accordingly, its own symptoms.

Articular form

So, the signs of the disease, identified in the region of the joints, speak of the articular form of rheumatism. The causes of the disease in this case are most often various infections. For example, children's rheumatism in some cases begins due to a sore throat, in such a case the infection affects the child's tonsils. You can see the principle of development in the photo. In addition, scarlet fever can serve as a reason for the development of rheumatism. But in any case, the true causes of the disease are not in the pathogen itself, but in the allergic restructuring of the body, in which streptococci cause rheumatism. In part, the reasons may lie in simple hypothermia.

Symptoms of the disease are pain in the joints of the legs, most often the knee, ankle. Also, the child has an increase in temperature, tumors of the affected areas of the legs occur. Usually the pain moves from one part of the body to another, from one joint to another and rarely manifests itself in the area of ​​the same joints for more than a week, most often the pain in one place lasts two to three days. In some cases, the child does not have a fever, and there are no tumors in the affected areas, but there are complaints of pain in the area of ​​\u200b\u200bthe joints of the arms or legs, which are also signs of rheumatism. Pain can pass quickly enough, but there is a danger of heart damage. It is important to recognize the symptoms of the disease in time and start treating the joints in order to protect the child from severe manifestations of rheumatism, especially those affecting the heart.

heart shape

Another form of the disease is cardiac. In this case, rheumatism carries the danger of heart valve disease. Symptoms in this situation are different. First of all, they touch the heart. The child does not complain of pain in the joints of the arms or legs. Signs in this case are fatigue while running and a rapid heartbeat. It is necessary to urgently consult a doctor, be examined and make an accurate diagnosis. An untimely visit to the doctor is fraught with a threat to the condition of the heart. Rheumatism is a dangerous disease that is not to be trifled with.

nervous form

Rheumatism, which occurs with the participation of the nervous system, first causes mental disorders in the child, such as excessive excitability and irritability, the child often cries for no reason. Often begin twitching of the muscles of the face, arms, legs. A child with these symptoms and signs should be seen by a doctor immediately. This form of the disease threatens with paralysis, the occurrence of problems with speech. This type of rheumatism is also called chorea and is most often observed not in adults, but in children and adolescents. Moreover, girls are more susceptible to it than boys.

Prevention

An important part of the fight against this disease. Prevention implies a number of rules: it is necessary that the body does not get cold, it is important to keep the feet warm, the child's body must receive enough vitamins and minerals. Proper nutrition is important. You should carefully monitor the hygiene of the oral cavity and tonsils, since it is in these ways that the infection usually enters the body.

It is necessary to support the child's immunity in order to avoid common diseases, such as sore throats, colds. Hardening contributes to the maintenance of immunity, it is recommended to take multivitamin complexes created specifically for children, who especially need nutrients due to their growth. In the case of immunodeficiency, immunostimulants are used. But when choosing a drug, you need to consult a doctor.

In the event of various signs of inflammatory diseases, the child needs bed rest and the intake of a large amount of liquid inside in order to remove the microbes that caused inflammation from the child's body as quickly as possible. It is also necessary to periodically visit a specialist to check the work of the heart. Prevention of rheumatism in children will help to significantly reduce the percentage of cases.

Treatment

With rheumatism, it is necessary to notice the signs of the disease in time, make an accurate diagnosis and begin treatment. Timely diagnosis of rheumatic fever is very important. With rheumatism, especially in children, self-medication is inappropriate, so a specialist must take care of children's health.

A sick child diagnosed with rheumatism must be treated in a hospital, observing strict bed rest for one to two weeks. The next stage, which takes about two to three weeks, is the same bed rest, but in a less strict version. For example, a child is allowed to participate in board games and does breathing exercises.

After that, the patient is transferred to the mode with a visit to the dining room and toilet. In the treatment of rheumatism, a diet that contains all the necessary vitamins and minerals, including potassium salt, plays a huge role. Food is recommended to be taken several times a day in small portions. Salty foods and hard-to-digest foods should be excluded from the diet.

If rheumatism takes on a nervous form, it must be taken into account that the patient needs complete rest, so it is better to keep him in a separate room. Soothing warm baths are shown. Coffee and cocoa, which can adversely affect the child's nervous system, should be excluded from the diet.

Folk remedies

Among the folk remedies there are those that improve the condition of the joints in children's rheumatism. Naturally, the treatment of children must be carried out in consultation with the doctor.

It is good for a child with a disease of the joints of the legs to eat wild berries, such as blueberries, lingonberries and cranberries. It is also good to include watermelon in the child's diet. Before breakfast, mix lemon juice with hot water and let your child drink. Extremely useful honey is highly recommended. It is useful to mix it with cranberry and lingonberry juice.

In case of pain in the joints of the legs, make compresses from potato gruel (grate fresh potatoes). The photo shows the sequence of this procedure. Compresses are also made from aspen leaves. Fresh leaves must first be steamed. To prepare therapeutic foot baths that can cope with rheumatism, blackcurrant leaves are used, a decoction boiled from pine buds. Another remedy available in the summer is a decoction of blackcurrant leaves, you need to drink it in half a glass three times a day.

At the present stage, the situation with rheumatism is improving. The cases of severe manifestations of the disease have become much less frequent, and the cases of lethal outcomes have significantly decreased. This is due to the constant fight against streptococcal infections.

Parents must remember that hardening, taking vitamin complexes and supporting the immunity of children are the main components of the prevention of rheumatism and other serious diseases in children. From the bottom of our hearts we wish health to you and your baby!

Orthopedist-traumatologist of the first category, Research Institute, 2012

Rheumatism in children in medical practice is not very common. The symptoms of this disease are multifaceted, since it affects not just a single organ or system, but the entire connective tissue. This disease is potentially dangerous for young patients, as it can cause irreversible complications in an unformed organism.

Rheumatism has a second name - Sokolsky-Buiko disease. This dysfunction is diagnosed mainly in children aged 7 to 15 years.

Rheumatism refers to allergic-infectious systemic diseases. It is able to affect the connective tissue of the central nervous system, heart and blood vessels, lungs, liver, kidneys and other organs. Rheumatism in children can occur due to the influence of several factors:

Improper nutrition, as well as hypothermia, stress provoke the development of the disease.

The pathogenesis of the disorder

Rheumatism can be active or inactive. The inactive phase is characterized by the absence of symptoms of inflammatory processes, hemodynamic disturbances, and the general stable state of health of the patient. The active phase of rheumatism is divided into several degrees:

1. Minimal activity: mild signs of illness;
2. Moderate activity: the results of laboratory, instrumental and clinical studies are more pronounced, but the patient's condition does not change much;
3. High activity: in the results of laboratory tests, characteristic changes are revealed, there are pronounced pathologies of the heart, joints and other organs.

The course of rheumatism can have a different character:

Symptomatic manifestations of childhood rheumatism

As previously stated, rheumatism affects the connective tissues in various organs. The body responds to the vital activity of streptococcus by actively synthesizing acute phase proteins, which stimulate inflammation. Symptoms of rheumatism usually appear already 1-2 weeks after infection of the body or activation of streptococcus.

Among the general symptoms of rheumatism, one can distinguish sharp hyperthermia, deterioration of health and severe weakness.

More specific symptoms of the disease depend on which organs or structures are affected. Most often, these are the joints (articular form), the heart (cardiac form) and the central nervous system (neurological form). Symptoms for each form of rheumatism are separate:

The active form of rheumatism is also characterized by disorders from other organs:

1. Pneumonia;
2. Nephritis;
3. Polyserositis;
4. Rheumatic nodes on the skin.

During periods of remission, children feel much better than with active rheumatism. They minimize the symptomatic manifestations of the disease, but this is on condition that the heart was not affected.

Diagnosis of the disease

It is recommended to visit the office of a pediatric rheumatologist if the child has recently been struck by a streptococcal infection, suffers from carditis, erythema or chorea, has symptomatic manifestations of polyarthritis or subcutaneous nodes have formed. If one of the close relatives suffered from rheumatism, it is better to play it safe and show the child to the doctor.

The rheumatologist will conduct an initial examination of the child and take an anamnesis, this is necessary to identify clinical. After that, the doctor will send him for instrumental and laboratory tests. The baby will need to do:

1. Clinical (with rheumatism there is a hyperconcentration of leukocytes and neutrophils, the erythrocyte sedimentation rate is increased) and biochemical (hemoglobin levels decrease, globulin levels increase, antibody titers to streptococci and C-reactive protein appears) blood test;
2. Blood for the detection of rheumatoid factor;
3. X-ray of the chest (determines the cardiac configuration and cardiomegaly);
4. ECG (to detect dysfunctions of the heart and its valves);
5. echocardiography;
6. Phonocardiography.

Ideally, it is necessary to start treating the disease in the first few days from its onset, then the risk of complications is almost zero.

Conservative therapy

Treatment of children's rheumatism should be timely and comprehensive. A rheumatologist deals with it, but in some cases the child can be observed in parallel by a pediatric cardiologist, dentist and otolaryngologist. The main goal of therapy is the neutralization of streptococci, the elimination of the inflammatory process and the restoration of immunity.

The first stage of treatment is the transfer of the child to the hospital and drug therapy. The course of treatment is quite long, it is at least a month and a half. The method of treating the disease directly depends on the phase of the pathology and the overall severity of the process. In most clinical cases, the tactics of drug therapy consists in prescribing:

1. Antibacterial drugs (penicillin antibiotics);
2. antiallergic agents;
3. Vitamin complexes (necessarily with vitamin C in the composition);
4. Non-steroidal anti-inflammatory drugs (drugs from the pyrazolone series and based on acetylsalicylic acid);
5. Immunomodulators;
6. Some maintenance medications (diuretics, heart medications) as needed.

Drug therapy can also be supplemented by physiotherapy procedures, a special diet is required. During inpatient treatment, the child is assigned to bed rest. If the disease is in stages 2-3, strict bed rest will be indicated for 2 weeks. As early as 3 weeks, the baby may be allowed to play in bed or do breathing exercises. It will be possible to get out of bed, go to the toilet and for lunch on your own, and do exercise therapy only after a month.

The second stage of treatment is sending the child to a sanatorium-resort institution. The main goal of sanatorium treatment is aftercare of the child. Therapy for childhood rheumatism is:

• A lighter version of drug therapy;
• air baths;
• Physiotherapy (quite often practiced mud therapy);
• Inactive games;
• Sanitation of foci of infection;
• Breathing exercises.

The last third stage is dispensary observation. After the final recovery of the child, a special medical card is started for him, which is kept in the hospital. The child is observed by the local pediatrician or cardio-rheumatologist. The main purpose of such monitoring is the prevention and timely detection of relapses of rheumatism.

Features of the treatment of sluggish rheumatism

Children with sluggish rheumatism (provided that the heart was not affected) are prescribed more gentle drug therapy. Additionally, physiotherapy is used. A distinctive feature of the treatment process is the absence of the need for inpatient treatment. It is enough for the child to visit the treatment room and appointments with the attending physician.

Proper medical nutrition

Diet is an integral part of the treatment of rheumatism. It must be observed at all stages of treatment, even during dispensary observation. The nutrition plan for the patient should be drawn up taking into account his age, the phase of the pathology (nutrition for acute rheumatism differs from the chronic diet), the presence of background diseases and other individual characteristics of the patient.

The main goal of diet therapy is to normalize the water-salt balance and the course of metabolic processes. Such priorities are due to the fact that there is a need to accelerate the removal of sodium and potassium from the tissues, since these two elements provoke complications from the cardiovascular system. One of the main rules of the diet is salt restriction. Great emphasis is placed on replacing part of the meal with proteins with fortified foods. This castling allows you to level the inflammatory process.

A patient with rheumatism should have 5 to 7 non-volume meals per day. The total daily calorie content of meals is a maximum of 2500 kcal, if the patient is assigned to bed rest - no more than 1800 kcal. Food is best boiled or steamed.

What can and can not be eaten with rheumatism?

The list of allowed and prohibited foods is generally relevant for any phase of the disease. Patients with rheumatism can eat:

• All vegetables and fruits in any form;
• Milk with a low fat content;
• Bread;
• Sugar (up to 30 grams per day);
• Products with vitamin C (oranges, lemons, currants and others);
• Foods fortified with vitamin E (oatmeal, nuts, olive oil);
• Products with selenium (offal, seafood, cereals);
• Chicken eggs;
• Different types of fish.

It is necessary to exclude:

1. Strong tea and coffee drinks;
2. Salty and spicy food;
3. Dishes with extractive substances;
4. Sauces and spices.

The specifics of nutrition in different phases of rheumatism

As already mentioned, the nature of the diet varies depending on the stage of the disease. The main aspects of nutrition in different phases of rheumatism:

• acute phase. More foods with potassium and vitamin C. Daily fluid intake - 1 liter. It is desirable to drink only clean water, fresh fruit drinks, compotes and juices are allowed. The diet is salt-free.
• Subacute phase. Increase the amount of protein and potassium-rich foods. The daily volume of liquid can be increased to one and a half liters. In the subacute phase, salt intake is allowed, but a maximum of 5 grams can be used.
• Chronic inactive phase. Sugar and all its derivatives are prohibited. The daily volume of liquid increases to 1.7 liters. The amount of protein required also increases, it must be consumed at least 100 grams per day.

Alternative therapy for rheumatism in children

Of the natural remedies, there are several that work most powerfully against the manifestations of rheumatism. The first such substance is turmeric. Curcumin, present in its composition, perfectly reduces the intensity of inflammation. Valid Recipes:

The next healing substance is propolis. Recipes with it:

A few more effective traditional medicine for rheumatism:

1. You will need pine needles and alcohol tincture. A liter jar is stuffed with needles and filled with alcohol. The jar is covered with a tight lid and infused for 3 weeks (during this time you need to shake it sometimes) away from sunlight. A few drops of tincture should be moistened with a sugar cube and taken orally 30 minutes before meals. This procedure is done up to 3 times a day.
2. Salt. With active rheumatism, you can make a salt-water compress on the affected area. If rheumatism is in remission, you can warm the affected area with red-hot salt (it is heated in a pan, then poured into a sock or towel).

It is important to remember that traditional medicine cannot affect the root cause of the pathology in any way and their action is directed mainly to the removal of symptomatic manifestations of rheumatism. Before resorting to any of the listed recipes, parents should definitely consult with the child's doctor.

Possible Complications

Among the most dangerous complications of rheumatism in children are:

Prevention of rheumatism in children

To avoid the occurrence of childhood rheumatism is quite simple, if you follow some rules of prevention. Among themselves, they can be divided into:

• Primary - are to prevent the disease;
• Secondary - their purpose is to prevent the progression and recurrence of the disease.

To minimize the risk of rheumatic fever, you need to:

1. Organize the life of the child. In his life, physical activity, proper nutrition, outdoor walks and hardening should be correctly combined.
2. Strengthen your child's mental health. Stress and emotional overload significantly deplete the immune system, and a weakened body, as you know, is more susceptible to viruses, it is more difficult for it to fight them.
3. Watch the child. Parents of a small patient should pay attention to his condition and the symptoms he complains about. This will help to catch diseases in the early stages of development and will not give them time to progress.
4. Timely start therapy against infections. If the disease is caught and treated almost immediately, the risk of complications will be minimal.

The parents of the child should remember that part of the responsibility for the health of the child depends not only on doctors, but also on themselves.

As for the prevention of relapses and exacerbation of rheumatism, it also consists in several aspects at once. Preventive measures are aimed at getting rid of foci of relapse and anti-relapse therapy, strengthening the protective function of the body. Also, children are recommended to undergo a course of cardiotrophic therapy.

is a disease of an allergic and infectious nature, systemically affecting the synovial membranes of the joints, the connective tissue of the heart and blood vessels, the serous membranes of the skin, the central nervous system, the eyes of the lungs, the liver and the kidneys.

In medical terminology, you can find another name for childhood rheumatism - Sokolsky-Buiko disease.

The average age at which this disease is diagnosed varies from 7 to 15 years. Rheumatism has no population limitation and is widespread throughout the world.

Symptoms of rheumatism in children

The first signs of the disease can be noticed at least a week after a streptococcal infection and a maximum of a month.

Symptoms of the manifestation of rheumatism are as follows:

Rheumocarditis. It is characterized by an inflammatory process in several or all layers of the heart wall, may be accompanied by pericarditis (damage to the outer lining of the heart), myocarditis (inflammation of the heart muscle), endocarditis (inflammation of the connective lining of the heart) and pancarditis (includes inflammation of all layers of the heart). Among the complaints made by young patients caused by rheumatic heart disease, fatigue, shortness of breath, pain in the heart, development can be noted.

Polyarthritis. It is accompanied by damage mainly to large and medium joints, the appearance of pain in them. The disease develops symmetrically.

Chorea. It affects more often girls and appears in the form of increased irritability, tearfulness, frequent mood swings. Then gait begins to suffer, handwriting changes, speech becomes slurred. In the most severe cases, the child will be unable to feed and care for himself.

Ring erythema. Accompanied by rashes that look like pale, slightly pinkish rings. Mostly located on the stomach and chest. The affected areas do not itch or peel.

Rheumatic nodules. They are formed in the form of subcutaneous formations, localized mainly on the back of the head and in the place where the joints join the tendons.

These are the five leading symptoms accompanying childhood rheumatism. In parallel, the patient may suffer from abdominal pain, nosebleeds. Dangerous are repeated attacks of rheumatism that occur a year later. At the same time, the symptoms of intoxication increase, heart defects develop, including: mitral valve prolapse, aortic insufficiency, aortic orifices, etc.

Causes of rheumatism in children

Among the causes leading to the development of rheumatism in childhood, include:

Firstly, acute respiratory infections, scarlet fever, pharyngitis, tonsillitis or tonsillitis, caused by group A hemolytic streptococcus. However, one infection is not enough for rheumatism to begin to develop. It is necessary that the infection provoked a malfunction, which, in turn, begins to "attack" healthy cells in the body. Often this is due to inadequate or untimely treatment of streptococcal infections.

Secondly, the hereditary factor. Studies show that rheumatism can be traced in members of the same family.

Thirdly, long-term carriage of streptococcal infection in the nasopharynx can provoke inadequate functioning of the immune system and cause rheumatism in childhood.

In addition, there are secondary factors influencing the development of the disease. These include overwork, hypothermia and poor nutrition, which, in turn, reduces immunity and increases the risk of contracting infectious diseases.

Both a pediatrician and a pediatric rheumatologist can suspect the presence of a disease in a child.

The reason for further research is the specific criteria that guide each doctor:

Any type of carditis;

The presence of chorea;

Formation of subcutaneous nodes;

Hereditary predisposition to rheumatism;

Positive response to specific therapy.

In addition, there are small evaluation criteria that make it possible to suspect a disease, these are: arthralgia, fever, specific blood parameters (accelerated ESR, neurophilic leukocytosis, etc.).

Therefore, in addition to studying the anamnesis, standard examination and questioning of the patient, it is necessary to carry out laboratory tests:

It also makes sense to have a chest x-ray. This study allows you to determine the configuration of the heart (mitral or aortic), as well as cardiomegaly.

Conducting an ECG will allow you to see violations in the work of the heart, and phonocardiography to determine the presence of damage to the valvular apparatus.

In order to indicate the presence of heart disease in a child, an echocardiogram is shown to him.

Complications of rheumatism in children

The disease is dangerous for its complications. Among them is the formation of heart disease. At the same time, its valves and partitions are affected, which leads to a violation of the functionality of the organ. Often the progression of the defect occurs with repeated attacks of the disease on the child's body. Therefore, it is so important to take the patient to a consultation with a cardiac surgeon in time and, if necessary, perform an operation in a specialized clinic.

Other possible complications include inflammation of the inner lining of the heart, thromboembolism, cardiac arrhythmias, and the formation of congestive heart failure. These conditions are deadly and can provoke the development of vital organs such as the spleen and kidneys. Often found, circulatory failure.

To avoid complications of the disease, it is important to notice the signs of rheumatism in a timely manner and begin treatment.

Children with a diagnosis of rheumatism are placed for treatment in a hospital. During the acute period of the illness, it is important that the patient stay in bed. Its duration is determined by the condition of the child and the nature of the disease. If rheumatism is mild, then bed rest should be followed for about a month. After this period, the child is prescribed physiotherapy exercises. Unlike an adult, it is difficult for children to maintain minimal activity. Therefore, parents need to properly organize his leisure time. Board games, coloring books, books, etc. will come to the rescue.

Drug treatment is reduced to the elimination of the pathogen that led to the development of the disease. Most often, antibiotic therapy based on penicillin is used for this. The drug is administered parenterally for 10 days. The minimum duration of such therapy is a week. The dosage is selected by the doctor individually and depends on the severity of the course of the disease and the weight of the child. Then bicillin-5 or 1 is used. When a child has an allergic reaction to penicillin, it should be replaced with erythromycin.

When the heart muscle and walls of the heart are affected, the child is prescribed glucocorticoids in combination with NSAIDs. The "acetylsalicylic acid + prednisolone" scheme is often used. If there is a visible effect, then gradually the drug is canceled by lowering the dose.

Popular modern drugs for the treatment of rheumatism are voltaren and metindol. They have strong anti-inflammatory effects.

When the heart muscle and walls of the heart are not affected, and the inflammatory process is insignificant, the patient is not recommended to take hormonal drugs. The doctor selects only anti-inflammatory drugs in the appropriate dosage.

In addition, the child needs auxiliary therapy, which consists in prescribing vitamin complexes, taking potassium preparations. Children usually spend up to 2 months in the hospital. Doctors who observe small patients are cardiologists and rheumatologists.

When the patient is in remission, he is shown sanatorium treatment. For prevention, a course of NSAIDs is used in the fall and spring. Reception time - 1 month.

Modern drugs that are advisable to use for the treatment of childhood rheumatism:

NSAIDs (indomethacin, voltaren, brufen, etc.);

Corticosteroid hormones (triamcinolone, prednisolone);

Immunosuppressants (delagil, chlorbutin, etc.).

With timely treatment to the doctor, the risk of death is minimized. Depending on the degree of damage to the heart, the severity of the prognosis for the disease will depend. If rheumatic carditis progresses and recurs, then this poses the greatest threat to the health of the child.

During the activation of the disease, it is important for a small patient to adhere to a certain diet, which is based on several principles:

Avoid foods rich in simple carbohydrates. This is due to the fact that such products often provoke allergic reactions during an exacerbation of the disease, which may not have previously been observed.

The menu should be as varied as possible with fruits and vegetables.

In the acute phase of the disease, it is necessary to eat one egg a day, excluding Sundays.

If there are serious disturbances in the work of the heart, then for several days (for 3 days), it is necessary to refrain from protein foods, eating only vegetables and fruits. You can drink up to 300 ml of milk per day.

It is important to saturate the body with vitamin C. Therefore, it is necessary to consume greens and citrus fruits.

It should be understood that the treatment of rheumatism should be comprehensive and based not only on taking medications, but also on well-organized nutrition, and on the correct daily routine.

Since the disease is dangerous with serious complications, its timely prevention is important. Regarding rheumatism, it is customary to single out both primary preventive measures and secondary ones. The former are aimed at preventing the disease and preventing infection of the child, and the latter at preventing cases of recurrence of the disease, as well as the progression of rheumatism.

In order to avoid the disease, preventive measures should be taken from childhood:

Firstly, it is necessary to competently organize the life of the child, this includes physical education, long pastime in the fresh air, hardening, proper nutrition with a low carbohydrate content.

Secondly, it is the strengthening of the child's psyche. These measures will help maintain the defenses at the proper level and, in case of infection, help the body cope with the infection faster.

Thirdly, the primary preventive measures include isolation of a patient with streptococcal infection and monitoring of contact children. This will allow timely identification of the infected and faster treatment, as well as preventing the spread of the disease in the teams.

Fourth, if an infection has occurred, it is necessary to start treatment as soon as possible. It has been proven that if the therapy of streptococcal infection is started no later than on the third day of infection, the risk of developing rheumatism is reduced to zero.

It is important for parents to realize that primary prevention is a necessary measure for which not only medical professionals are responsible. To preserve the health of the child, it is necessary to be attentive to any symptoms of malaise and seek qualified help in time.

As for secondary prevention, it is due to the tendency of rheumatism to recur. Therefore, children with a similar diagnosis are under medical supervision for a long time. They are observed by a rheumatologist, cardiologist, orthopedist and other narrow specialists.

It is important to maintain the patient's immunity at the proper level, which will ensure a high resistance of the body to rheumatism. In addition, doctors should have special control over children whose families have cases of the disease among close relatives, including brothers and sisters.

Education: Diploma in the specialty "Medicine" received at the Volgograd State Medical University. He also received a certificate of a specialist in 2014.