Understanding Rheumatic Fever
Rheumatic fever is a disease that affects the joints, heart, and central nervous system. It is caused by inflammation in the body from a strep infection. 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 or another strep infection. If the strep infection goes untreated or under treated, inflammation can 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 or another strep infection.
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
To diagnose rheumatic fever healthcare providers look for specific clinical symptoms such as fever, joint inflammation, rash or nodules under the skin, abnormal heart rhythms or murmurs, and signs of nerve inflammation. In addition, you may have a throat culture, blood tests, electrocardiogram, and echocardiography.
How is rheumatic fever treated?
The main concern for rheumatic fever is its effect on the heart. Treatment is aimed at stopping the inflammation that is leading to 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 take antibiotics for several years to prevent another episode of strep throat.
What are the complications of rheumatic fever?
Complications may include:
Permanent heart damage may show up years after the first acute episode of rheumatic fever, so long-term follow-up care is needed. If a child has rheumatic fever, the information should always be included in the permanent health history, even into adulthood, because the person will need regular heart exams the rest of his or her life.
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 by your healthcare provider
Pain that gets worse
Symptoms that don’t get better, or get worse