Rheumatic Fever Causes, Prevention, Symptoms And Treatment


Rheumatic fever is an inflammatory illness that can result from untreated strep throat or scarlet fever. An infection with streptococcus bacteria is what causes strep throat and scarlet fever.

Children aged 5 to 15 are most frequently affected by rheumatic fever. Yet, both adults and younger children may experience it. Rheumatic fever is uncommon in the United States and other affluent nations, although strep throat is often encountered.

Rheumatic fever can lead to permanent heart failure and heart valve damage. Treatment can ease pain, reduce the consequences of inflammation, and prevent the recurrence of rheumatic fever.


After contracting a throat infection from the germs Group A streptococcus, rheumatic fever may develop. Strep throat or, less commonly, scarlet fever can arise from throat infections with Group A streptococcus.

Infections with Group A streptococcus of the skin or other parts of the body are commonly the cause of rheumatic fever.

It is not understood how strep infection and rheumatic fever are connected. The immune system seems to be tricked by the germs into attacking normally healthy tissue.

The immune system of the body generally targets germs that cause infections. The immune system incorrectly assaults healthy tissue in rheumatic fever, especially in the heart, joints, skin, and central nervous system. This defective immune response causes the tissues to grow (inflammation).

When a strep throat infection is immediately treated, the risk of developing rheumatic fever is minimal.

Rheumatic fever can develop in children if one or more cases of strep throat or scarlet fever go untreated.

How to check if you have Rheumatic Fever?

If any of these indications of strep throat appear, schedule a visit with your child's doctor:

  • Rapid onset of a sore throat
  • Swallowing discomfort
  • Fever
  • Headache
  • Vomiting, nausea, and stomach discomfort
  • Rheumatic fever can be avoided with the right strep throat care.

Risk Factors

Rheumatic fever may be brought on by a number of factors, including:

Genes. Some individuals may have one or more genes that increase their risk of contracting rheumatic fever.

A particular strain of strep bacterium. Rheumatic fever is more likely to be caused by specific strep bacteria strains than by others.

Environmental variables. Overcrowding, poor sanitation, and other factors that might let strep bacteria readily spread among numerous individuals are linked to a higher risk of rheumatic fever.


Rheumatic fever symptoms are brought on by inflammation of the heart, joints, skin, or central nervous system. There might be a few or many symptoms. Symptoms might change as the condition worsens. Two to four weeks following strep throat, rheumatic fever frequently develops.

Signs and symptoms of rheumatic fever might include:

  • Fever
  • Joints that are sore and sensitive, most frequently in the knees, ankles, elbows, and wrists
  • Joint pain that spreads to another joint
  • Joints that are red, heated, or swollen
  • Chest pain
  • Fatigue
  • Painless, ragged-edged rash that is flat or slightly elevated
  • Heart murmur
  • Jerky, uncontrolled bodily movements, most frequently in the hands, feet, and face (Sydenham chorea).
  • Unusual behavioral outbursts that accompany Sydenham, such as sobbing or inappropriate laughter
  • Cholera
  • Skin-deep, painless lumps


The best way to prevent rheumatic fever is to treat strep throat infections or scarlet fever early and properly with a sufficient course of antibiotics.


Treatment for rheumatic fever aims to eliminate the infection, lessen symptoms, reduce inflammation, and stop the disease from coming back.

Rheumatic fever treatment options include:

Antibiotics. To treat the strep bacteria, a prescription for penicillin or another antibiotic is frequently given.

When the original course of antibiotics has been finished, a doctor frequently suggests another treatment to prevent a recurrence of rheumatic fever. The youngster will likely get preventative treatment until they are 21 years old or until they have completed a minimum five-year therapy course, whichever comes first.

Individuals who have cardiac inflammation during rheumatic fever may require 10 years or more of prophylactic antibiotic therapy.

Medications that reduce inflammation. Inflammation, fever, and discomfort can be reduced by aspirin or naproxen (Naprosyn, Naprelan, Anaprox DS). 

If the inflammation is severe or a child's condition does not improve with anti-inflammatory drugs, a corticosteroid may be administered. Provide aspirin only if instructed to do so by a healthcare professional.

Anti-seizure medication. To treat the severe involuntary movements brought on by Sydenham chorea, drugs such as valproic acid or carbamazepine (Carbatrol, Tegretol, etc.) may be utilized.

Continuing care

What kind of long-term treatment and follow-up your child will require for rheumatic fever should be discussed with your healthcare professional.

Rheumatic heart disease, often known as rheumatic fever heart damage, may not manifest for years or even decades. Any history of rheumatic fever should always be disclosed to your healthcare professional.

Complications of Rheumatic Fever

Rheumatic fever-related inflammation might extend for a few weeks to many months. Some patients get long-term difficulties as a result of the inflammation.

Permanent cardiac damage is one rheumatic fever consequence (rheumatic heart disease). Years to decades after the initial sickness, rheumatic heart disease typically develops.

While your child is still experiencing the infection's symptoms, severe rheumatic fever can begin to harm the heart valves. The mitral valve, which connects the heart's two left chambers, is the one where damage occurs most frequently, but other valves can also be harmed.

The following forms of cardiac injury can be brought on by rheumatic fever:

  • Heart valve narrowing (valve stenosis). Blood flow is reduced as a result.
  • Heart valve leak (valve regurgitation). The valve is crossed by backward blood flow.
  • Damage to the heart muscle. The heart's capacity to pump blood is weakened by the inflammation brought on by rheumatic fever.
  • Heart failure or chaotic, irregular heartbeats (atrial fibrillation) can result from damage to the heart valves or other cardiac components later in life.


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Page last reviewed: Jul 12, 2023

Next review due: Jul 12, 2025

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