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Rheumatic Fever
Rheumatic fever is a complication of strep throat. If it's left untreated, it can cause permanent damage to your heart. Find out about symptoms...

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Rheumatic Fever

Rheumatic fever is one of the complications associated with strep throat. It’s a relatively serious illness that can cause stroke, permanent damage to your heart, and death if it’s left untreated.

The condition usually appears in children between the ages of 5 and 15, even though older children and adults have been known to contract the fever as well. It’s still common in places like sub-Saharan Africa, south central Asia, and certain populations in Australia and New Zealand.

What Causes Rheumatic Fever?

Rheumatic fever is caused by group A streptococcus. This bacterium causes strep throat or, in a small percentage of people, scarlet fever. It’s an inflammatory disorder.

Rheumatic fever causes your body to attack its own tissues after it’s been infected with the bacteria that causes strep throat. This reaction causes widespread inflammation throughout your body, which is the basis for all of the symptoms of rheumatic fever.

What Are the Symptoms of Rheumatic Fever?

Rheumatic fever is caused by a reaction to the bacteria that causes strep throat, group A streptococcus. Although not all cases of strep throat result in rheumatic fever, this serious complication may be prevented with diagnosis and treatment of strep throat. If your child has any of the following symptoms, they should get a strep test:

  • a sore throat
  • a sore throat with tender and swollen lymph nodes
  • a red rash
  • difficulty swallowing
  • thick, bloody discharge from nose
  • a temperature of 101°F or above
  • tonsils that are red and swollen
  • tonsils with white patches or pus
  • small, red spots on the roof of their mouth
  • a headache
  • nausea
  • vomiting

A wide variety of symptoms are associated with rheumatic fever. An individual with the illness could experience a few, some, or most of the following symptoms. Symptoms usually appear two to four weeks after your child has been diagnosed with strep throat. Common symptoms of strep throat include:

  • small, painless nodules, or bumps, under the skin
  • chest pain
  • rapid fluttering or pounding chest palpitations
  • lethargy or fatigue
  • nosebleeds
  • stomach pain
  • painful or sore joints in the wrists, elbows, knees, and ankles
  • pain in one joint that moves to another joint
  • red, hot, swollen joints
  • shortness of breath
  • a fever
  • sweating
  • vomiting
  • a flat, slightly raised, ragged rash
  • jerky, uncontrollable movements of their hands, feet, and face
  • a decrease in attention span
  • outbursts of crying or inappropriate laughter

If your child has a fever, they might require immediate care. You should seek immediate medical care for your child in the following situations:

  • a temperature over 100°F in newborns to 6-week-old infants
  • a temperature of 102°F or higher in babies 6 weeks to 2 years old
  • a temperature of 103°F or higher in children age 2 years or older
  • a fever that lasts more than three days in a child of any age

How Is Rheumatic Fever Diagnosed?

Your doctor will first want to get a list of your child’s symptoms and their medical history. They’ll also want to know if your child has had a recent bout of strep throat. Next, a physical exam will be given that includes the following:

  • looking for rash or skin nodules, which are hard bumps beneath the skin
  • listening to their heart to check for abnormalities
  • performing movement tests to determine their nervous system dysfunction
  • examining their joints for inflammation
  • testing their blood for strep bacteria
  • performing an electrocardiogram, which measures the electric waves of their heart
  • performing an echocardiogram, which uses sound waves to produce images of their heart

Effective Treatments for Rheumatic Fever

Treatment will involve getting rid of all of the residual group A strep bacteria and treating and controlling the symptoms. This can include any of the following:


Your doctor will prescribe antibiotics and might prescribe a long-term treatment to prevent it from occurring again. This treatment can last up to five years.

Anti-Inflammatory Treatment

Anti-inflammatory treatments include pain medications that are also anti-inflammatory, such as aspirin or naproxen. Doctors may also prescribe a corticosteroid to reduce inflammation.

Anticonvulsant Medications

Your doctor might prescribe an anticonvulsant if involuntary movements become too severe.

Bed Rest

Your doctor will also recommend bed rest and restricted activities until the major symptoms like pain and inflammation have passed. Strict bed rest will be recommended for a few weeks to a few months if the fever has caused heart problems.

Risk Factors for Rheumatic Fever

Factors that increase your child’s chances of developing rheumatic fever include:

  • a family history because certain genes make you more likely to develop rheumatic fever
  • the type of strep bacteria present because certain strains are more likely to lead to rheumatic fever than others
  • environmental factors present in developing countries, such as poor sanitation, overcrowding, and a lack of clean water

How to Prevent Rheumatic Fever

The most effective way to make sure that your child doesn’t develop rheumatic fever is to treat their strep throat infection quickly and thoroughly. This means making sure your child completes all prescribed doses of medication. In addition, schedule a follow-up visit to ensure that your child is free from strep bacteria antibodies.

Practicing proper hygiene methods can help prevent strep throat. These include:

  • covering your mouth when coughing or sneezing
  • washing your hands
  • avoiding contact with people who are sick
  • avoiding sharing personal items with people who are sick

Complications Associated with Rheumatic Fever

Once they develop, the symptoms of rheumatic fever can last for months. Rheumatic fever can cause long-term complications in certain situations. One of the most prevalent complications is rheumatic heart disease. Other heart conditions include:

  • valve stenosis, which is a narrowing of a valve
  • valve regurgitation, which is a leak in the valve that causes blood to flow in the wrong direction
  • heart muscle damage, which is an inflammation that can weaken the heart muscle and decrease the heart’s ability to pump blood effectively
  • atrial fibrillation, which is an irregular heart beat in the upper chambers of the heart
  • heart failure, which happens when the heart can no longer pump blood to all parts of the body


The long-term effects of rheumatic fever can be disabling if your child has a severe case. Some of the damage caused by the illness might not show up until years later. Be aware of long-term effects as your child grows older. Children who suffer from long-term damage related to rheumatic fever may be eligible for special education and other related services.

Written by: Shannon Johnson
Edited by:
Medically Reviewed by:
Published: Aug 15, 2012
Published By: Healthline Networks, Inc.
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