Symptoms and Signs of Rheumatic Fever

Medical Author:
Medically Reviewed on 8/13/2021

Doctor's Notes on Rheumatic Fever

Rheumatic fever is a complication of strep throat caused by infections of group A streptococcal bacteria that can cause damage to the heart, brain, joints, and skin. 

The main symptom is a fever (usually under 102 degrees F) that occurs 1-5 weeks after a bout of strep throat. Other symptoms of rheumatic fever include:

  • joint swelling and pain (arthritis, often in the large joints such as knees, shoulders, and hips), 
  • heart problems (inflammation and eventual destruction of heart valves that can lead to heart failure), 
  • Sydenham's chorea (sudden involuntary movements of muscles due to irritation of specific areas of the brain), 
  • skin problems (erythema marginatum, 
  • a pink rash that looks serpentine and surrounds areas of normal looking skin), and 
  • round and painless lumps over bones such as the knees and elbows.

What Is the Treatment for Rheumatic Fever?

  • The first step in treatment is to ensure that the underlying infection is controlled. 
  • If the underlying cause is a Streptococcus infection, antibiotics are used. Once the immunologic response has begun that causes rheumatic fever, however, treatment of the infection may not change the development of the condition.
  • Anti-inflammatory medications and pain control medications are used to manage joint pain.
  • High-dose steroids or other medications are usually needed to manage heart problems related to rheumatic fever.
  • If chorea is present, specialized medications may be given to manage this symptom.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.