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Rheumatic Fever

Last Updated November 2023 | This article was created by editorial staff and reviewed by Daron Gersch, MD, FAAFP

What is rheumatic fever?

Rheumatic fever is a rare inflammatory disease. It mostly happens in areas that don’t have access to health care. It usually doesn’t happen in the United States. Children ages 5 to 15 are at greatest risk of getting rheumatic fever.


Rheumatic fever affects your heart, brain, joints, and skin. Common symptoms include fever, sore throat, stomach pain, and nosebleeds. You may have shortness of breath or chest pain. Other symptoms include:

  • Joint pain and swelling
  • Skin rash that could be red or hot
  • Small bumps under your skin
  • Sydenham chorea (a rare neurological condition marked by spasms and frantic emotions)

What causes rheumatic fever?

Rheumatic fever happens after you have a Group A streptococcus bacterial infection. These infections include strep throat and scarlet fever. If you’re not treated for these infections, the bacteria can eventually make your immune system attack your body’s healthy tissue. Rheumatic fever begins 14 to 28 days after the initial infection.

How is rheumatic fever diagnosed?

First, your doctor will ask about your symptoms. They will do a physical exam. This includes looking at your joints and skin, and listening to your heart. Next, they can perform several tests. A blood test or throat culture can detect a strep infection. An electrocardiogram (EKG) uses electrical signals to check your heart rate and rhythm. A sedimentation rate or a C-reactive protein (CRP) checks for inflammation.

Your doctor will group your symptoms and test results into two categories. In order to diagnose rheumatic fever, you must have strep throat and either 2 major symptoms or 1 major symptom and 2 minor ones.


Major symptoms
Minor symptoms
Arthritis, particularly in large joints, such as elbows, wrists, knees, and ankles Fever
Skin bumps Joint pain
Skin rash Abnormal EKG
Spasms, or quick, jerky motions High ESR or CRP
Inflammation of your heart

Can rheumatic fever be prevented or avoided?

Visit your doctor if you have signs of strep throat. This can prevent the infection from turning into rheumatic fever.

Rheumatic fever treatment

The main treatment for rheumatic fever is antibiotics. These will get rid of the bacteria. They also can help keep you from getting rheumatic fever again. Adults and teenagers may need to take antibiotics for up to 5 years. Children may need to take them up to age 21.

Your doctor may prescribe other medicines to treat your symptoms. Seizure medicine can help with the jerky motions or spasms. Aspirin or corticosteroids can help reduce swelling or inflammation.

Living with rheumatic fever

Although strep throat is contagious, rheumatic fever is not. When treated, you can recover from rheumatic fever. You may have short- or long-term damage to your heart. This can include rheumatic heart disease. Because of the long-term effects, you’ll need to have an ongoing treatment plan with your doctor.

Questions to ask your doctor

  • Does the risk of rheumatic fever go away if I’m treated when I have strep throat or scarlet fever?
  • What is my risk of getting rheumatic fever if I’ve had strep throat in the past?
  • Can I get rheumatic fever more than once?
  • Why do I have to take antibiotics for so many years?
  • What side effects do the antibiotics have?
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