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Rheumatic Fever

  • Cynthia M. Johnson, MA
Publication Type:


Rheumatic Fever


Rheumatic fever is a disease marked by inflammation of tissue. The heart valves, skin, joints, and nerves can all be affected. Rheumatic fever can also cause lasting damage to the heart.

Diseased Heart Valve.

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Rheumatic fever is caused by the body's response to a type of bacteria that causes strep throat. The body makes antibodies to fight the infection, but they also mistakenly attack healthy tissue in the body. It is not clear why this happens.

Risk Factors

Rheumatic fever is more common in children 5 to 15 years of age. Other things that raise the risk are having:

  • Strep throat or scarlet fever and
    • Not being treated with antibiotics
    • Not being fully treated with antibiotics
  • A history of rheumatic fever
  • Crowded areas and living conditions


Symptoms usually appear 2 to 4 weeks after a strep infection. They may include:

  • Pain in muscles or large joints
  • Fever
  • Weakness
  • Cough or problems breathing
  • Chest pain
  • Nausea and vomiting
  • Lumps under the skin or a rash
  • Abnormal, sudden movements of the arms and legs


The doctor will ask about symptoms and past health. A physical exam will be done. This will include a careful exam of the heart. Tests will be done to look for signs of infection, such as:

  • Blood tests
  • Throat culture—to test for certain types of bacteria

Pictures of the heart may be taken to look for any damage. This can be done with:

The electrical activity of the heart may be tested. This can be done with an electrocardiogram.


Many people will begin treatment in the hospital. The goal will be to kill the strep bacteria and stop the inflammation. This can be done with:

  • Over the counter pain relievers
  • Antibiotics to treat infection
  • Corticosteroids to ease inflammation and joint pain

Other treatments may be needed for related health problems, such as heart complications.


The risk of this problem may be lowered by treating strep throat and scarlet fever as early as possible.





  • Acute rheumatic fever. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-rheumatic-fever.
  • Lahiri S, Sanyahumbi A. Acute rheumatic fever. Pediatr Rev. 2021;42(5):221-232.
  • Rheumatic fever. Texas Heart Institute website. Available at: https://www.texasheart.org/heart-health/heart-information-center/topics/rheumatic-fever.


  • David L. Horn, MD, FACP
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.