Understanding Rheumatic Fever

Rheumatic fever is a disease that affects the joints, heart, and central nervous system. It causes inflammation in the body. It is most common in children ages 5 to 15. Since the development of antibiotics, most cases today occur only in developing countries.

What causes rheumatic fever?

Rheumatic fever can develop after a strep throat infection. If strep throat goes untreated or undertreated, the strep bacteria attack the heart, joints, and the nervous system.

Certain things may raise the risk for rheumatic fever. Genes may play a part. So may the environment. The disease tends to happen more often in places where there is overcrowding or a lack of medical care. Rheumatic fever also occurs in people who have strep throat but don’t know they have it because they don’t have any symptoms.

What are the symptoms of rheumatic fever?

Symptoms usually start 2 to 4 weeks after an infection with strep throat.

Some symptoms can be severe, such as those that affect the heart. Symptoms may include:

  • Short-term arthritis that moves from joint to joint, such as the knees and wrists

  • Inflammation of the heart and heart valve. This may cause problems like a heart murmur or chest pain (rheumatic heart disease).

  • Sydenham chorea. This is a nervous system disorder that results in uncontrolled movements, muscle weakness, and behavioral changes.

  • Bumps under the skin, often near the elbow, knees, or ankles

  • Ring-shaped pink rash on the upper arms and torso

  • Fever

  • Stomachache

  • Rash

How is rheumatic fever treated?

The main concern for rheumatic fever is its effect on the heart. Treatment is aimed at stopping serious heart problems and easing other symptoms. Treatments include:

  • Rest.  Plenty of rest can help lessen joint pain. It may also limit heart damage.

  • Antibiotics. Antibiotics are given to kill any lasting strep bacteria in the body.

  • Anti-inflammatory medicine. Aspirin can reduce feverand inflammation. You may need a steroid for severe symptoms.

People with one episode of rheumatic fever may need to continue antibiotics for several years to prevent another episode of strep throat.

What are the complications of rheumatic fever?

  • Heart disease with leaking heart valves or an enlarged heart

  • Heart failure

When should I call my healthcare provider?

Call your healthcare provider right away if you have any of these:

  • Fever of 100.4°F (38°C) or higher, or as directed

  • Pain that gets worse

  • Symptoms that don’t get better, or get worse

  • New symptoms