BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuRheumatic feverStreptococcus - rheumatic fever; Strep throat - rheumatic fever; Streptococcus pyogenes - rheumatic fever; Group A streptococcus - rheumatic feverRheumatic fever is a disease that may develop after an infection with group A streptococcus bacteria (such as strep throat or scarlet fever). It can cause severe illness in the heart, joints, skin, and brain.Strep throatStrep throat is a disease that causes a sore throat (pharyngitis). It is an infection with a germ called group A streptococcus bacteria.Read Article Now Book Mark Article Scarlet feverScarlet fever is caused by an infection with bacteria called group A streptococcus. This is the same bacteria that cause strep throat.Read Article Now Book Mark Article Causes Rheumatic fever is still common in countries that have a lot of poverty and poor health systems. It does not often occur in the United States and other developed countries. When rheumatic fever does occur in the United States, it is most often in small outbreaks. The latest outbreak in the United States was in the 1980s.Rheumatic fever occurs after infections with a germ or bacteria called Streptococcus pyogenes or group A streptococcus. This germ appears to trick the immune system into attacking healthy tissues in the body. These tissues become swollen or inflamed.This abnormal reaction seems to almost always occur with strep throat or scarlet fever. Strep infections that involve other parts of the body do not seem to trigger rheumatic fever. Symptoms Rheumatic fever mainly affects children ages 5 to 15 who have had strep throat or scarlet fever. If it occurs, it develops about 14 to 28 days after these illnesses.Symptoms can affect many systems in the body. General symptoms may include:Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...Read Article Now Book Mark Article Nosebleeds Pain in the abdomen Heart problems, which may have no symptoms, or may lead to shortness of breath and chest pain Symptoms in the joints can:Cause pain, swelling, redness, and warmth Mainly occur in the knees, elbows, ankles, and wrists Change or move from one joint to another Skin changes may also occur, such as:Ring-shaped or snake-like skin rash on the trunk and upper part of the arms or legs Skin lumps or nodules A condition that affects the brain and nervous system, called Sydenham chorea, can also occur. Symptoms of this condition are:Sydenham choreaSydenham chorea is a movement disorder that occurs after infection with certain bacteria called group A streptococcus.Read Article Now Book Mark Article Loss of control of emotions, with bouts of unusual crying or laughing Quick, jerky movements that mainly affect the face, feet, and hands Exams and Tests Your health care provider will examine you and will carefully check your heart sounds, skin, and joints.Tests may include:Blood test for repeated strep infection (such as an ASO test) ASOAntistreptolysin O (ASO) titer is a blood test to measure antibodies against streptolysin O, a substance produced by group A streptococcus bacteria. ...Read Article Now Book Mark Article Complete blood count (CBC) Complete blood countA complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...Read Article Now Book Mark Article Electrocardiogram (ECG) ElectrocardiogramAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.Read Article Now Book Mark Article Sedimentation rate (ESR -- a test that measures inflammation in the body) Sedimentation rateESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...Read Article Now Book Mark Article Several factors called major and minor criteria have been developed to help diagnose rheumatic fever in a standard way. The major criteria for diagnosis include:Arthritis in several large joints Heart inflammation Nodules under the skin Rapid, jerky movements (chorea, Sydenham chorea) Skin rash The minor criteria include:Fever High ESR Joint pain Abnormal ECG You'll likely be diagnosed with rheumatic fever if you:Meet 2 major criteria, or 1 major and 2 minor criteria Have signs of a past strep infection Treatment If you or your child is diagnosed with acute rheumatic fever, you or your child will be treated with antibiotics. The goal of this treatment is to remove all of the strep bacteria from the body.After the first treatment is complete, more antibiotics are prescribed. The goal of these medicines is to prevent rheumatic fever from recurring.All children will continue the antibiotics until age 21. Teenagers and young adults will need to take antibiotics for at least 5 years.If you or your child had heart problems when the rheumatic fever occurred, antibiotics may be needed for even longer, perhaps for life.To help manage swelling of inflamed tissues during acute rheumatic fever, medicines such as aspirin or corticosteroids may be needed.For problems with abnormal movements or abnormal behaviors, medicines often used to treat seizures may be prescribed. Outlook (Prognosis) Rheumatic fever can cause severe heart problems and heart damage. Possible Complications Long-term heart problems can occur, such as:Damage to heart valves. This damage may cause leakage in the heart valve or narrowing that slows blood flow through the valve. Damage to the heart muscle. Heart failure. Heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...Read Article Now Book Mark Article Infection of the inner lining of your heart (endocarditis). EndocarditisEndocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium). It is caused by a bacterial or, rarely a fun...Read Article Now Book Mark Article Swelling of the membrane around the heart (pericarditis). PericarditisPericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.Read Article Now Book Mark Article Heart rhythm that is fast and unsteady. Heart rhythm that is fast and unsteadyAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...Read Article Now Book Mark Article Sydenham chorea. When to Contact a Medical Professional Contact your provider if you or your child develops symptoms of rheumatic fever. Because several other conditions have similar symptoms, you or your child will need careful medical evaluation.If symptoms of strep throat develop, tell your provider. You or your child will need to be checked and treated if strep throat is present. This will decrease the risk of developing rheumatic fever. Prevention The most important way to prevent rheumatic fever is by getting quick treatment for strep throat and scarlet fever.Open ReferencesReferencesCarr MR, Shulman ST. Rheumatic heart disease. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 465.Mocumbi AO. Rheumatic fever. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 81.Shulman ST, Jaggi P. Nonsuppurative poststreptococcal sequelae: rheumatic fever and glomerulonephritis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 198.Stevens DL, Bryant AE, Hagman MM. Nonpneumococcal streptococcal infections and rheumatic fever. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 274.AllVideoImagesTogRelated Information Strep throat(Condition)Scarlet fever(Condition)Mitral stenosis(Condition)Endocarditis(Condition)Heart failure(Condition)Arrhythmias(Condition)Pericarditis(Condition)Heart failure(In-Depth) Review Date: 1/29/2022 Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. 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