Rheumatic Fever
What is rheumatic fever?
Rheumatic fever is a disease that causes inflammation (swelling and redness) of many parts of the body. The disease can damage the heart, joints, brain, and skin.
What is the cause?
Rheumatic fever is caused by a reaction to a strep throat infection. Why some people have this reaction to strep bacteria is not well understood. Rheumatic fever may happen when your body’s defense against infection attacks the body as well as the strep germ. It can affect different parts of the body.
Most people with strep throat do not get rheumatic fever. You are more at risk for rheumatic fever if you have had:
- An untreated strep infection
- An incompletely treated infection because you didn’t finish all of the medicine prescribed for you, or
- Several strep infections
You can have rheumatic fever at any age, but it is most common in children.
What are the symptoms?
Symptoms, which usually start 2 to 3 weeks after a sore throat, may include:
- Aching and swollen joints (ankles, knees, elbows, wrists), with the pain and swelling often moving from joint to joint
- Fever
- Tiredness
- Chest pain
- Shortness of breath
- Jerky, uncontrollable movements of the face, arms, and legs
- Red, flat, painless, and nonitching rash on the chest and belly or arms and legs
- Small bumps under the skin on the elbows or knees
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:
- Blood tests
- A throat culture
- Chest X-ray
- An echocardiogram, which uses sound waves (ultrasound) to see how well the heart is pumping
- An ECG (also called an EKG or electrocardiogram), which measures and records the heartbeat
How is it treated?
The treatment may include:
- Antibiotic medicine to kill the strep bacteria
- Medicine to control fever, joint pain, and inflammation
- Steroid drugs to treat inflammation of the heart
- Medicine to help control jerky movements
- Bed rest until you have a normal temperature without medicine
- Several weeks of decreased activity
Rheumatic fever can last from 6 weeks to more than 6 months. Your long-term health depends on how your heart has been affected by the disease. Rheumatic fever can weaken the heart muscle and affect your heart’s ability to pump. The heart valves may also be affected. One or more valves may become scarred and after a while may have trouble opening and closing properly. Damage to the valves may not show up until years after the illness. Eventually, the valve may need to be repaired or replaced with surgery. Starting antibiotic treatment early when you have rheumatic fever may prevent permanent damage to the heart. You may also need medicines to treat any heart symptoms.
It is very important to keep from getting rheumatic fever again. Repeated infections increase the chances of permanent heart damage. You may need to take antibiotics before dental treatments or any kind of surgery.
How can I take care of myself?
- Take all medicines as prescribed.
- Take the full course of antibiotics prescribed by your healthcare provider. You may need to take an antibiotic regularly for months or years to prevent another strep infection. You may also need to take antibiotics before having dental work or surgery to help keep your heart from getting infected.
- Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider’s approval. You may have to lower your dosage slowly before stopping it.
- Drink lots of fluids
- Follow the full course of treatment prescribed by your healthcare provider. Ask your healthcare provider:
- How and when you will hear your test results
- How long it will take to recover
- If there are activities you should avoid and when you can return to your normal activities
- How to take care of yourself at home
- What symptoms or problems you should watch for and what to do if you have them
- Make sure you know when you should come back for a checkup.
How can I help prevent rheumatic fever?
Tell your healthcare provider if you have a
- Sore throat and fever that last more than 24 hours
- Severe sore throat without cold symptoms
- Sore throat after being around someone with a strep throat
Treating strep throat infections with antibiotics can usually prevent rheumatic fever.