Rheumatic Fever – Symptoms and Causes

ByJanis Updated

Overview

Rheumatic fever is an inflammatory condition that develops after inadequate treatment of strep throat or scarlet fever infections. These infections stem from streptococcus bacteria.

This disease primarily affects children between 5 and 15 years old, but it can occur in younger children and adults as well.

This condition has become uncommon in developed nations. The most serious concern with rheumatic fever is its potential to cause permanent heart damage, including valve problems and heart failure.

Treatment typically involves:

  • Antibiotics to eliminate the streptococcus bacteria
  • Pain management medications
  • Preventive medicines to avoid complications

Early diagnosis and proper treatment are essential to prevent long-term health issues from this inflammatory disease.

Signs and Symptoms

Rheumatic fever typically develops about 2 to 4 weeks after a strep throat infection. The condition causes inflammation in several body parts, including the heart, joints, skin, and central nervous system.

Symptoms can range from mild to severe and may change or come and go during the illness.

Common symptoms of rheumatic fever include:

  • Fever
  • Joint pain and swelling (especially in knees, ankles, elbows, and wrists)
  • Joints that feel hot or tender
  • Pain that moves from one joint to another
  • Chest discomfort
  • Unusual tiredness
  • Small, painless bumps under the skin
  • Flat or slightly raised rash with uneven edges that doesn’t cause pain

Some people develop Sydenham chorea, which causes:

  • Jerky, uncontrolled movements, mainly in the hands, feet, and face
  • Sudden crying or inappropriate laughing

Medical Care Guidelines

See a doctor right away if you notice these signs of strep throat, as proper treatment can prevent rheumatic fever:

  • Sudden sore throat
  • Pain when swallowing
  • High temperature
  • Headache
  • Stomach discomfort, feeling sick, or throwing up

Causes

Rheumatic fever typically develops after an untreated or improperly treated throat infection caused by group A streptococcus bacteria. These bacteria are responsible for strep throat and scarlet fever.

The risk of developing rheumatic fever decreases significantly when strep throat infections are promptly treated with a complete course of antibiotics. It’s essential to finish all prescribed medication, even if symptoms improve before the medicine is gone.

While throat infections are the primary trigger, skin infections or infections in other body parts rarely lead to rheumatic fever.

Scientists aren’t completely sure how strep infections lead to rheumatic fever. The current theory suggests the bacteria might confuse the immune system, causing it to attack healthy tissues instead of just the bacteria. This mistaken immune response primarily affects:

  • Heart
  • Joints
  • Skin
  • Central nervous system

This incorrect immune reaction results in inflammation (swelling) of various joints and tissues throughout the body.

Risk Factors

Several factors may raise your chance of getting rheumatic fever:

  • Genetic Factors: Some people have genes that make them more likely to develop this condition.

  • Bacterial Type: Certain strains of strep bacteria pose a higher risk than others for causing rheumatic fever.

  • Living Conditions: Crowded spaces and poor sanitation help strep bacteria spread easily between people. These environments significantly increase rheumatic fever risk.

Understanding these risk factors can help with prevention efforts, especially in high-risk populations.

Complications

Rheumatic fever can cause swelling in joints and tissues that may last from several weeks to months. For some people, this swelling leads to serious long-term health problems.

The most significant complication is rheumatic heart disease. This condition typically develops years or even decades after the initial infection. In severe cases, heart valve damage can begin while a child is still experiencing symptoms of rheumatic fever.

The mitral valve, which sits between the left heart chambers, is most commonly affected. However, other heart valves may also sustain damage. Heart complications from rheumatic fever include:

  • Valve Stenosis: Heart valves become stiff and thick, sometimes fusing together and restricting blood flow.
  • Valve Regurgitation: Improper valve closure allows blood to flow backward.
  • Weakened Heart Muscle: Inflammation can damage the heart’s pumping ability.
  • Heart Failure: Valve damage may lead to heart failure later in life
  • Atrial Fibrillation (AFib): Heart damage can cause irregular, rapid heartbeats.

People with a history of rheumatic fever should inform all healthcare providers about their condition. This information helps doctors monitor for potential heart issues that might develop years after the initial illness.

Prevention

Stopping rheumatic fever begins with proper treatment of strep throat and scarlet fever. When these infections occur, seeking immediate medical care is essential.

If antibiotics are prescribed, take the entire course exactly as directed, even if symptoms improve. Stopping medication early can allow bacteria to survive and potentially cause complications.

Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.