Rheumatic Fever: Symptoms, Causes, Treatment


Rheumatic fever is an inflammatory disease that often occurs after a group A streptococcal throat infection. It is a complication of strep throat or scarlet fever. Rheumatic fever can cause severe, even life-threatening illness in the heart, joints, skin, and brain. The greatest danger of the condition is the damage to the heart, which may lead to rheumatic heart disease, eventually causing the heart to fail. It is a rare disease but most common in younger children between the ages of 5 and 15. According to various statistics, rheumatic fever affects less than 200,000 people in the US population annually, and the average incidence rate is approximately 1 in 83.


Rheumatic fever is mainly caused by a bacterium called group A Streptococcus. Group A streptococcus infections of the throat cause strep throat, or less commonly, scarlet fever. However, the link between strep throat and rheumatic fever is not yet clear. It is estimated that fewer than 0.3% of people with strep throat ever contract rheumatic fever.

The bacterium can cause the immune system to attack healthy tissues in the body. These tissues will become swollen or inflamed. Therefore, a weakened immune system may be involved in the development of the disease.


A lot of symptoms are associated with rheumatic fever. Symptoms usually appear two to four weeks after experiencing a strep infection. Common symptoms include:

  • Fever
  • Joint pain
  • Red, hot or swollen joints
  • Small, painless bumps under the skin
  • A flat, slightly raised, ragged rash
  • Jerky, uncontrollable movements of the hands, feet, and face
  • Chest pain
  • Fatigue
  • Sweating
  • Vomiting
  • Heart murmur
  • Heart inflammation
  • Heart failure


To diagnose rheumatic fever, the doctor will first conduct a physical exam to look for a rash or skin nodules and listen to the patient’s heart to check for any abnormalities. Besides, other tests and procedures may be done:

  • Blood tests

A blood test can help detect antibodies to the strep bacterium by circulating in the blood. The doctor will also check for inflammation in the blood by measuring C-reactive protein and the erythrocyte sedimentation rate.

  • Electrocardiogram (ECG)

This test records electrical signals as they travel through the patient’s heart. These signals may indicate inflammation of the heart or poor heart function so that the doctor can check and conform the condition.

  • Echocardiogram

It uses sound waves to produce live-action images of the heart. The doctor can detect heart abnormalities in this test.


Treatment options for rheumatic fever are shown as follows:

  • Antibiotics

The doctor will prescribe penicillin or other antibiotics to eliminate remaining strep bacteria. The treatment may be a long-term one to prevent it from occurring again. People suffering from heart inflammation during rheumatic fever might need to take the preventive antibiotic treatment for 10 years or longer.

  • Anti-inflammatory treatment

The doctor will prescribe a pain reliever, such as aspirin or naproxen, to reduce inflammation, fever and pain. If your symptoms are severe or do not respond to the anti-inflammatory drugs, the doctor might prescribe a corticosteroid.

  • Anticonvulsant medications

The doctor might prescribe an anticonvulsant, such as valproic acid or carbamazepine, if the involuntary movements get severe.

  • Bed rest or hospitalization

The doctor will also recommend bed rest and restricted activities until the major symptoms disappear. Strict bed rest in hospital will be recommended if the condition causes serious heart problems.

Keywords: Rheumatic fever

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.