Rheumatic fever is a complex disease that affects the joints, skin, heart, blood
vessels, and brain. It occurs mainly in children between the ages of 5 to 15. It's
autoimmune disease that occurs after an infection with strep (streptococcus) bacteria.
Strep infections include strep throat and scarlet fever. Rheumatic fever happens more
often in the winter and spring. This is because strep throat infections occur more
in these seasons. Strep is contagious. This means it can be spread from child to child,
but rheumatic fever is not contagious.
Rheumatic fever is an autoimmune reaction to the strep bacteria. An autoimmune reaction
is when the body attacks its own tissues. It can be prevented if strep throat is
diagnosed right away and treated correctly with antibiotics. Rheumatic fever is not
common in the U.S.
Children ages 5 to 15 are most at risk for having rheumatic fever. They are most at
risk if they:
strep throat infections often
strep infections that were not treated or not treated enough
- Have a
family history of rheumatic fever
symptoms usually start about 1 to 5 weeks after a child has been infected with strep
bacteria. Each child’s symptoms may vary. Common symptoms can include:
- Inflammation in joints, such as the knees or ankles, that causes swelling, soreness,
painless, hard bumps (nodules) under the skin, often over bony areas
jerky movements, most often of the face and hands. This is often noted by a change
a child's handwriting.
- Red rash
with odd edges on the torso, arms, or legs
- Lack of
These symptoms can seem like other health conditions. Have your child see their
healthcare provider for a diagnosis.
child’s healthcare provider will take your child’s health history and do a physical
exam. Your child may also have tests, such as:
child's healthcare provider will look for:
- Inflammation of the heart
- Inflammation of more than one joint
hard bumps under the skin
- Pain in
one or more joints
- Previous inflammation of the heart
in the ECG pattern
- Abnormal sedimentation rate or C-reactive protein in blood tests
Treatment will depend on your child’s symptoms, age, and general
health. It will also depend on how severe the condition is.
Treatment for rheumatic fever often combines the following 3 things:
The first step is to treat the strep infection with antibiotics.
This is done even if a throat culture is negative. Your child may need to take
monthly doses of antibiotics to prevent future strep infections. This is to help
prevent the rheumatic fever from recurring and further damaging the body.
Anti-inflammatory medicines. Your child may take medicines to help decrease
the swelling that occurs in the heart muscle. These medicines also help ease joint
The length of bed rest will depend on how severe your child's illness
is. Bed rest may range from 2 to 12 weeks.
with your child’s healthcare provider about the risks, benefits, and possible side
effects of all medicines.
the illness severely attacks a child's heart, this may damage heart valves and cause
heart disease. In this case, your child may not be allowed to do some kinds of physical
activity and sports.
the heart were damaged, your child would need to take special care when going to the
dentist in the future. They may need to take antibiotics before having dental work
This helps lower the chance of an infection traveling to the heart during a dental
procedure. Talk with your child's healthcare provider for more information.
best way to prevent rheumatic fever is to treat strep throat infections promptly and
complete the entire course of antibiotics. .
Having rheumatic fever increases your child's chances of having the disease again.
is at highest risk during the first 3 years. The chance of having the disease again
lessens with age and time.
having rheumatic fever, your child will need to take antibiotics on an ongoing basis.
This is to lessen the chance of having rheumatic fever again. Antibiotics (usually
penicillin) may be given by mouth or by a monthly injection. Talk with your child's
provider about how long this treatment is needed. This depends on the severity of
child's rheumatic fever and is usually continued at least 5 years or until age 21,
whichever is longer. Some people, like those with heart valve problems, may need to
antibiotics for life. Your child's provider will be able to help you learn more.
When to Call a Healthcare Provider
the healthcare provider if your child's symptoms get worse or they have new
- Rheumatic fever is a complex disease that affects the joints, skin, heart, blood
vessels, and brain.
occurs after an infection with strep bacteria, such as strep throat or scarlet
may include joint inflammation, small, hard bumps under the skin, jerky movements,
rash, and fever.
- Treatment includes antibiotics, anti-inflammatory medicine, and bed rest.
child will need to have ongoing treatment to stop the disease from coming back.
to help you get the most from a visit to your child’s healthcare provider:
the reason for the visit and what you want to happen.
your visit, write down questions you want answered.
- At the
visit, write down the name of a new diagnosis and any new medicines, treatments, or
tests. Also write down any new instructions your provider gives you for your
- Know why
a new medicine or treatment is prescribed and how it will help your child. Also know
what the side effects are.
- Ask if
your child’s condition can be treated in other ways.
- Know why
a test or procedure is recommended and what the results could mean.
what to expect if your child does not take the medicine or have the test or
- If your
child has a follow-up appointment, write down the date, time, and purpose for that
how you can contact your child’s healthcare provider after office hours. This is
important if your child becomes ill and you have questions or need advice.