Rheumatic Fever

Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever. Strep throat and scarlet fever are caused by an infection with group A streptococcus bacteria.

Rheumatic fever is most common in 5- to 15-year-old children, though it can develop in younger children and adults.

Rheumatic fever can cause permanent damage to the heart, including damaged heart valves and heart failure. Treatments can reduce tissue damage from inflammation, lessen pain and other symptoms, and prevent the recurrence of rheumatic fever.

The symptoms may also change during the course of the disease. Rheumatic fever signs and symptoms — which result from inflammation in the heart, joints, skin or central nervous system — may include:

  • Fever
  • Painful and tender joints — most often the ankles, knees, elbows or wrists; less often the shoulders, hips, hands and feet
  • Pain in one joint that migrates to another joint
  • Red, hot or swollen joints
  • Small, painless nodules beneath the skin
  • Chest pain
  • Heart murmur
  • Fatigue
  • Flat or slightly raised, painless rash with a ragged edge (erythema marginatum)
  • Jerky, uncontrollable body movements (Sydenham chorea or St. Vitus’ dance) — most often in the hands, feet and face
  • Outbursts of unusual behavior, such as crying or inappropriate laughing, that accompanies Sydenham chorea

Call your doctor about a fever in the following situations:

  • Newborns up to 3 months old with a fever of 100.4 F (38 C) taken rectally
  • Children ages 3 to 6 months with a temperature of 102 F (38.9 C) or higher
  • Children ages 6 months to 2 years with a fever of 102 F (38.9 C) or higher that doesn’t respond to medication or lasts more than one day
  • Children ages 2 to 17 years with a fever of 102 F (38.9 C) or higher (taken rectally for children younger than 3 and orally for children older than 3) that doesn’t respond to medication or lasts more than three days

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