Rheumatic Fever
What is rheumatic fever?
Rheumatic fever is an inflammatory reaction that can happen after a streptococcal infection of the throat (“strep throat”) if not treated properly. Most strep throat infections don’t lead to rheumatic fever. When they do, the time between strep throat and rheumatic fever is about two to three weeks.
Rheumatic fever is not contagious; however, the strep infection that comes before it can be spread from person to person. If a strep throat infection is treated, rheumatic fever can almost always be prevented. Anyone can get rheumatic fever, but those who do are most often 5 to 15 years old.
What are the symptoms of strep throat?
The symptoms may be mild in some children. If your child has a sore throat, you can’t know for sure if it’s strep throat unless you take them to a health care professional and have them tested.
Some common symptoms of strep throat (pharyngitis) include:
- Sore throat that can come on quickly
- Pain when swallowing
- Fever
- Red and swollen tonsils, sometimes with white patches or streaks
- Small red spots on the roof of the mouth
- Swollen lymph nodes in the neck
Some less common symptoms, especially in children, may include:
- Headache
- Stomach pain, nausea or vomiting
How can rheumatic fever affect my child?
Rheumatic fever can affect the heart, joints, skin and nervous system. Symptoms can vary but may include:
- High fever
- Painful, tender, red, swollen joints (arthritis)
- Shortness of breath or difficulty breathing, especially with exertion (carditis)
- Skin rash that doesn’t itch, especially on the chest or abdomen
- Lumps under the skin
- Rapid heartbeat
- Chest pain
- Involuntary movement (chorea)
How is it treated?
The symptoms of rheumatic fever are treated with medications to reduce fever, pain and general inflammation. Antibiotics are also given to treat group A strep infections.
How can rheumatic fever affect the heart?
Rheumatic fever does not always affect the heart. When it does, the damage can go away or become permanent, depending on which part of the heart is affected. When rheumatic fever causes lasting heart damage, it’s called rheumatic heart disease.
When rheumatic fever affects the heart, it usually affects the heart valves, especially the mitral and aortic valves. This can cause new or worsened heart murmurs. The heart inflammation may permanently damage the heart valves.
Heart failure may also develop. This can cause your child to feel tired and short of breath or develop a cough.
Do I need to limit my child’s activities?
Many pediatricians recommend that you limit their activities until the illness subsides. Talk to your child’s health care professional because the answer can vary from child to child.
Can you get rheumatic fever more than once?
Your child is more likely than others to have another “attack.” Your child’s health care professional will prescribe an antibiotic (usually penicillin) for them to take for an extended period, usually at least 10 years. The antibiotic prevents strep throat and protects your child from getting rheumatic fever again.
How can I protect my child from more problems?
People with rheumatic heart disease are at risk of developing an infection on their damaged heart valves. This infection is called infective endocarditis. You can help reduce your child’s risk for this by having them maintain good oral hygiene.
Your child may also need to take antibiotics before certain dental or surgical procedures if they have:
- A history of infective endocarditis
- A prosthetic heart valve or heart valve repair with prosthetic material
- Certain types of congenital heart defects
- Had a heart transplant and developed heart valve problems
Talk about your child’s medical history with their health care professional to find out if they are in this category.
