Rheumatic Fever

What is rheumatic fever?

Rheumatic fever is a disease that causes inflammation, swelling, and redness of various parts of the body. The disease can damage your heart, joints, central nervous system, and skin.

How does it occur?

Rheumatic fever is a complication that may happen after an infection with group A Streptococcus bacteria. These bacteria are the cause of strep throat. Rheumatic fever may occur at any age, but it is most common in children 5 to 15 years old. Poverty and overcrowded living conditions may increase the risk of getting the disease.

What are the symptoms?

The symptoms, which usually begin 1 to 6 weeks after a sore throat, include:

fever
tiredness
stomach pain
vomiting
aching and swollen joints (ankles, knees, elbows, wrists), with the pain and swelling often moving from joint to joint
irregular, jerky, uncontrollable movements of your face, arms, and legs
pea-sized bumps just under the skin, usually over large bony areas like your knees
areas of pink rash with clear centers
weakness and shortness of breath.

How is it diagnosed?

There is no single definitive test for rheumatic fever. Your health care provider will ask about your symptoms and medical history and examine you. You may have:

a test for antibodies to the strep bacteria in your blood
an electrocardiogram (ECG) of your heart to check for abnormal heartbeats.

How is it treated?

Your health care provider may prescribe:

penicillin or another antibiotic to kill the strep bacteria
aspirin or steroid drugs to control fever, joint pain, and inflammation
sedatives and tranquilizers to help control jerky movements
bed rest until your temperature returns to normal without medicine (anywhere from 3 weeks to 3 months).

How long will the effects last?

Your long-term health depends on how your heart has been affected by the disease. Rheumatic fever can weaken the heart muscle and affect the heart's ability to pump. The heart valves may also be affected. The valves may become deformed and may not close or open properly. Damage to the valves may not show up until years after the illness. Damaged valves may become infected if they are exposed to bacteria during surgery or dental work. Starting antibiotic treatment early when you have rheumatic fever may prevent permanent damage to the heart.

It is very important to prevent recurrences of rheumatic fever because the severity of heart trouble is related to the number of attacks of rheumatic fever. You may have to take penicillin regularly for months or years to prevent further strep infections.

How can I take care of myself?

Make sure that you take the full course of antibiotics prescribed by your health care provider.
Before you have surgery or dental work, take antibiotics to prevent infection of the heart.
Stay in bed and rest while you are recovering.
Drink lots of fluids.
Call your provider if you have:
- a sore throat again
- upset stomach, ringing in the ears, headaches, or very fast breathing, which may be reactions to taking aspirin often
- trouble breathing
- pain near your heart
- high fever even though you are taking your prescribed medicine.

How can I help prevent rheumatic fever?

Tell your health care provider if you have a sore throat and fever that last more than 24 hours, or if you have a severe sore throat without cold symptoms. If you have been exposed to someone with a strep throat and you now have a sore throat, see your provider. Treating strep throat infections with antibiotics can usually prevent rheumatic fever.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File INF4527F.HTM Release 9.0/2006