Rheumatic Fever

What is rheumatic fever?

Rheumatic fever is a rare inflammatory disease. It mainly is found in countries that are poor or don’t have access to health care. There has not been an outbreak in the United States since the 1980s. Children ages 5 to 15 are at greatest risk of getting rheumatic fever.

Symptoms of 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 can range from:

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

What causes rheumatic fever?

Group A streptococcus bacterial infection can lead to rheumatic fever. This occurs when the bacteria attack your immune system. It causes your healthy body tissue to become inflamed. Rheumatic fever begins about 14 to 28 days after the infection. It is linked to strep throat and scarlet fever. Kids and adults who have one of these conditions and aren’t treated are at risk.

How is rheumatic fever diagnosed?

First, your doctor will do a physical exam. They will look at your joints and skin, and listen 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 (ESR) test checks for inflammation.

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

Major Minor
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
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. You likely will need to have an ongoing management and treatment plan with your doctor.

Questions to ask your doctor

  • What is my risk of getting rheumatic fever if I have or have had strep throat?
  • If I’ve had rheumatic fever can I get it again?