Rheumatic Fever

What is Rheumatic Fever?

Rheumatic Fever is an acute fever that causes inflammation and joint pain. It can lead to damage of the heart, stroke or even death if it goes untreated.  It is a complication of having strep throat and appears most often in children between 5-15 years of age.

Older children and adults can get rheumatic fever, too.  In some countries, like Africa, Asia, and some parts of Australia and New Zealand, it is still fairly common but it does not occur in other countries very frequently.

This inflammatory disorder is caused by group A streptococcus that causes inflammation through the entire body and can derive from untreated strep throat or scarlet fever.

What are the Symptoms of Rheumatic Fever?

Not all strep throat infections result in rheumatic fever and if the strep throat is treated quickly it can be avoided.  Strep throat is characterized by a sore throat, sometimes with swollen and sore lymph nodes, rash, a temperature over 100 degrees Fahrenheit (38 °C), white spots on the tonsils, bloody discharge from the nose, nausea, headache, and vomiting.

If these symptoms occur, a doctor should be seen immediately.

Rheumatic fever symptoms occur 2-4 weeks after being diagnosed with strep throat and include nodules or bumps under the skin, nosebleeds, fatigue, heart palpitations or flutters, joint pain and swelling, shortness of breath, stomach pain, fever, vomiting, and rash.

Rheumatic Fever Causes

Rheumatic fever is not a disease but is caused by having another infection. The direct cause of rheumatic fever is an untreated or inadequately treated infection with the streptococcus group A bacteria. This is the same group of bacteria that causes what is commonly known as strep throat.

When the strep A bacteria enters the body and it is not eliminated, it can begin an immune response in the body. This immune system response often targets the heart valves and the joints leading to rheumatic fever.

Some physicians believe that there is a genetic cause of rheumatic fever. Those who acquire rheumatic fever often have a family history of the condition.

How is Rheumatic Fever Treated?

There are several course of treatment for rheumatic fever.  Antibiotics are usually the first step and doctors might prescribe antibiotics over the longer term to prevent rheumatic fever from reoccurring. Pain medications and corticosteroids may be prescribed to address inflammation. If involuntary movements are part of the symptoms, anticonvulsant medications may be prescribed.  Finally, bed rest and restricted activities are recommended for as long as a few months, depending on the severity of the rheumatic fever.

Rheumatic Fever Prevention

Since it is well established that infection with streptococcus A is the cause of rheumatic fever, it is of vital importance that any strep throat infection is treated with a course of antibiotics. It is very important that the complete course of antibiotics be taken in order to insure that the bacteria has been eliminated from the body. A doctor may perform a second strep test after the antibiotics are finished to check that there is no lingering infection.

Preventing strep throat infections will also lead to the prevention of rheumatic fever. In order to lessen the occurrence of strep throat, general sanitary measures are extremely helpful. One of the best means to prevent any bacterial or viral infection is to wash the hands thoroughly and frequently. This is especially true during the cold and flu season when strep bacteria are prevalent.

Since there may be a genetic factor linked to rheumatic fever, those who have a family history of rheumatic fever need to alert their primary care provider of this history. This will allow the healthcare provider to be even more diligent in making sure that all strep A is eradicated during an infection.