Rheumatic Fever

Rheumatic fever is a serious, delayed complication of streptococcal infections, including strep throat and scarlet fever. It is an inflammation in the connective tissues throughout the body. Connective tissues in the heart, joints and just below the skin are especially susceptible. Although strep throat usually is an acute illness with fever, sore throat and headache, the inflammation resulting from rheumatic fever can cause permanent damage to the heart valves, causing disability or death many years after the acute illness.

Rheumatic fever is rare in the United States, occurring in about 3 percent of all cases of untreated streptococcal infection. (Strep throat can be caused by different strains of group A strep, but just a few of these strains are responsible for most cases of rheumatic fever.) Rheumatic fever affects mostly children between the ages of 5 and 15, although adults can also develop rheumatic fever.

Symptoms appear from one to five weeks after a strep throat infection. An acute attack usually lasts about three months; rarely will it last longer than six months. While blood tests can confirm a previous strep infection, there is no test available to confirm the diagnosis of rheumatic fever. Doctors make their diagnosis of rheumatic fever based on evidence of a recent strep infections along with at least two of the symptoms that are characteristic of the disease (called major symptoms) or one major and two minor symptoms. Rheumatic fever is difficult to diagnose because other diseases could cause any of the symptoms and because there is no test that will definitely diagnose the disease.

What to Do

Call your child's doctor if you think your child has strep throat. The doctor can order a strep test and give you antibiotics if necessary. If strep is confirmed, make sure your child takes the full amount of antibiotics prescribed, typically 10 days of therapy. This reduces the risk of complications, including rheumatic fever.

Use Medicine Effectively

Early treatment of strep throat with antibiotics can prevent rheumatic fever, but antibiotics cannot stop rheumatic fever once it has developed. Antibiotics, however, will kill any group A strep bacteria that remain in the body and that could spread to other people. Treatment for rheumatic fever includes anti-inflammatory medicine to reduce joint pain and fever. If you have had rheumatic fever, your doctor may give you long-term antibiotics to prevent future streptococcal infection that could cause heart damage or worsen heart damage from the initial attack. The length of time a person remains on preventive antibiotics is determined on an individual basis. If you have heart damage from rheumatic fever, you will need to take preventive antibiotic medicine before any dental or surgical procedures.

Self-care Steps for Rheumatic Fever

Make sure that you and your child wash hands before preparing food, particularly if you have been sneezing or coughing. This can help prevent the spread of the bacteria that cause strep throat.