Rheumatic Fever

What causes Rheumatic Fever?

Rheumatic fever is a delayed, autoimmune reaction to the streptococcus bacteria. It can be prevented by prompt diagnosis of a strepococcal throat and treatment with antibiotics.

What are the symptoms of Rheumatic Fever?

The symptoms of rheumatic fever usually start about one to five weeks after your child has been infected with the streptococcus bacteria. The following are the most common symptoms of rheumatic fever. However, each child may experience symptoms differently.

Symptoms may include:

• Joint inflammation - including swelling, tenderness, and hotness over multiple joints. The joints affected are usually the larger joints in the knees or ankles. The inflammation "moves" from one joint to another over several days.
• Small nodules or hard, round bumps under the skin
• A change in your child's movements (this is usually noted by a change in your child's handwriting and may also include jerky movements)
• A rash - a pink rash with odd edges that is usually seen on the trunk of the body or arms and legs
• Fever
• Weight loss
• Fatigue
• Stomach pains.

Symptoms of rheumatic fever may resemble other medical conditions. Always consult your doctor for a diagnosis.

How is rheumatic fever diagnosed?

There is no one test to diagnose rheumatic fever. Blood tests are usually performed to assist in making a diagnosis. Your child's doctor may also order an electrocardiogram (ECG), as part of the diagnostic process for rheumatic fever. A throat swab may also be taken to find out if the child tests positive for streptococcus bacteria, although during the initial phase of rheumatic fever, the throat culture is often negative.

What is the treatment for Rheumatic Fever?

Children with rheumatic fever are often treated in the hospital, depending upon the severity of the disease. Treatment for rheumatic fever, in most cases, combines the following three approaches:

1. Treatment for streptococcus infection
The immediate goal is to treat the infection with antibiotics. This is done even if the throat culture is negative. Following the initial treatment for strep infection, your child may continue to receive monthly doses of antibiotics to help prevent further complications.

2. Anti-inflammatory medications
Based on the severity of your child's condition, your child's doctor may prescribe medications to help decrease the swelling that occurs in the heart muscle, as well as to relieve joint pain.

3. Bed rest
The length of bed rest will be determined by your child's doctor, based on the severity of your child's disease and the involvement of the heart and joints
Bed rest may range

How can Rheumatic Fever be controlled?

Rheumatic fever is likely to come back in people who don't take low-dose antibiotics continually, especially during the first 3 -5 years after the first episode of the disease. Heart complications may be severe, particularly if the heart valves are involved.

When to contact a Doctor.
Call your health care provider if you develop symptoms of rheumatic fever. Because several other conditions have similar symptoms, you will need careful medical evaluation. If you have symptoms of strep throat, tell your health care provider.
You will need to be evaluated and treated if you do have strep throat, to decrease your risk of developing rheumatic fever.

Are there any complications from having rheumatic fever?

Depending on the severity of the initial attack of the disease on the heart, some children may develop heart disease. Exercise and sports may be restricted; your doctor will be able to advise you based on your child’s condition.

Some children my need antibiotics before having dental work done. This helps decrease the chance of infection reaching the heart during the dental procedure. Consult your child's doctor or dentist for more information.