What is Rheumatic Fever? A Patient's Guide to the Condition

Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated strep throat, which is caused by infection with group A Streptococcus bacteria. It primarily affects children between 5 and 15 years old, although it can occur at any age. Understanding rheumatic fever is important because it can lead to serious complications, especially affecting the heart.

What causes rheumatic fever?

Rheumatic fever occurs as a result of the body's immune response to a strep throat infection. When the immune system fights off the infection, it can sometimes mistakenly attack the body's own tissues, leading to inflammation. This inflammatory response can damage the heart, joints, skin, and brain. The exact reasons why some individuals develop rheumatic fever after a strep infection while others do not are not fully understood, but genetic factors and the specific strain of the bacteria may play a role.

Symptoms of rheumatic fever

Symptoms of rheumatic fever can vary widely and may develop 2 to 4 weeks after a strep throat infection. Common symptoms include:

• Fever
• Painful and swollen joints, often in the knees, ankles, elbows, and wrists
• Red, hot, or swollen skin over the affected joints
• Small, painless nodules under the skin
• A characteristic rash, often with a pink ring pattern (erythema marginatum)
• Shortness of breath or chest pain (due to heart inflammation)
• Uncontrolled movements of the limbs or face (Sydenham's chorea)

How is rheumatic fever diagnosed?

Diagnosing rheumatic fever involves a combination of medical history, physical examination, and laboratory tests. A doctor will typically look for evidence of a recent strep infection, such as a positive throat culture or a blood test showing elevated levels of antistreptolysin O (ASO) antibodies. They may also use echocardiography to assess any heart involvement. The diagnosis is often based on a set of criteria known as the Jones criteria, which include major and minor clinical findings.

Treatment and management

The primary goals in treating rheumatic fever are to eliminate the streptococcal bacteria, reduce inflammation, and manage symptoms. Antibiotics, such as penicillin, are commonly prescribed to eradicate the bacteria. Anti-inflammatory medications like aspirin or corticosteroids may be used to control inflammation and relieve joint pain. Long-term preventive antibiotics may be recommended to prevent recurrence, especially in individuals with heart involvement.

Frequently asked questions

Is rheumatic fever contagious? Rheumatic fever itself is not contagious, but the streptococcal infection that precedes it can be spread from person to person through respiratory droplets.

Can adults get rheumatic fever? While less common, adults can develop rheumatic fever, particularly if they have a history of untreated or improperly treated strep infections.

How long does rheumatic fever last? The duration of rheumatic fever can vary, with symptoms potentially lasting for several weeks to months. Long-term management may be necessary for heart-related complications.

When to see a doctor

If you or your child experiences symptoms of strep throat, such as a sore throat, fever, or swollen lymph nodes, it is important to seek medical evaluation and treatment. Prompt treatment of strep throat with antibiotics can prevent rheumatic fever. If symptoms of rheumatic fever develop, such as joint pain, rash, or unusual movements, consult a healthcare provider promptly to prevent complications.

Remember, this information is for educational purposes only. Decisions about your health should always be made in consultation with your healthcare provider.