What is rheumatic fever?
Rheumatic fever is a disease that causes inflammation, swelling,
and redness of various parts of the body. The disease can damage
your heart, joints, brain, and skin.
How does it occur?
Rheumatic fever is a disease caused by a reaction to streptococcus
bacteria. These bacteria are the same germs that cause strep
throat. Exactly why and how some people have this reaction to
strep bacteria is not well understood. It appears to involve an
abnormal response of the body's immune system.
Most people with strep throat do not get rheumatic fever. You are
more at risk for rheumatic fever if you have had several strep
infections. It may occur at any age, but it is most common in
children.
What are the symptoms?
Symptoms, which usually begin 2 to 3 weeks after a sore throat,
may include:
- aching and swollen joints (ankles, knees, elbows, wrists),
with the pain and swelling often moving from joint to joint
- tiredness
- shortness of breath
- jerky, uncontrollable movements of your face, arms, and legs
- fever
- abdominal pain.
Sometimes, but not commonly, there are pink or light red,
nonitching blotches on your skin or small bumps under the skin on
your elbows or knees.
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical
history and will examine you. There is no single definitive test
for rheumatic fever. The diagnosis is based on:
- history of a previous strep throat infection
- symptoms
- evidence of heart inflammation.
You may have tests such as:
- a blood test to look for antibodies to the strep bacteria
- a chest X-ray
- an ultrasound scan of the heart
- an electrocardiogram (ECG) to check for abnormal heartbeats
and rhythms.
How is it treated?
Your healthcare provider may prescribe:
- penicillin or another antibiotic to kill the strep bacteria
- aspirin to control fever, joint pain, and inflammation
- steroid drugs to treat inflammation of the heart
- medicine such as a tranquilizer to help control jerky
movements
- bed rest until you have a normal temperature without medicine
- several weeks of decreased activity.
How long will the effects last?
Rheumatic fever can last from several weeks to more than several
months. Your long-term health depends on how the heart has been
affected by the disease. Inflammation caused by rheumatic fever
can weaken the heart muscle and affect the heart's ability to
pump. The heart valves may also be affected. One or more valves
may become scarred and after a while may have trouble opening and
closing properly. Damage to the valves may not show up until years
after the illness. Eventually, the valve may need to be repaired
or replaced with surgery. Starting antibiotic treatment early when
you have rheumatic fever may prevent permanent damage to the
heart.
It is very important to prevent recurrences of rheumatic fever
because the severity of heart trouble is related to the number of
attacks of rheumatic fever. You may have to take penicillin
regularly for months or years to prevent further strep infections.
How can I take care of myself?
- Make sure that you take the full course of antibiotics
prescribed by your healthcare provider.
- Damaged valves may become infected if they are exposed to
bacteria during surgery or dental work. Infection of the valve
can damage it more. Antibiotics can help prevent infection.
Ask your healthcare provider if you should take antibiotics
before you have dental work or procedures that involve the
rectum, bladder, or vagina.
- Follow your provider's advice for decreased activity while you
are recovering.
- Call your provider if you have:
- a sore throat again
- upset stomach, ringing in the ears, headaches, or very
fast breathing, which may be reactions to taking aspirin
often
- trouble breathing
- pain near your heart
- a fever of 101.5°F (38.6°C) or higher even though you are
taking your prescribed medicine.
How can I help prevent rheumatic fever?
Tell your healthcare provider if you have a sore throat and fever
that last more than 24 hours, or if you have a severe sore throat
without cold symptoms. If you have been exposed to someone with a
strep throat and you now have a sore throat, see your provider.
Treating strep throat infections with antibiotics can usually
prevent rheumatic fever.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
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