Rheumatic Fever

Rheumatic fever is a rare complication that occurs after an infection with Streptococcus pyogenes bacteria. The most common type of S. pyogenes infection is "strep throat," in which the tissues that line the pharynx become infected with the bacteria. Rheumatic fever does not occur if the initial strep infection is treated with antibiotics. Major symptoms of rheumatic fever include infection of the protective layers of the heart, arthritis (an inflammation of the joints), skin rashes, and chorea (a condition characterized by abrupt, purposeless movements of the face, hands, and feet). Rheumatic fever is treated with antibiotics, but recurrences are common. To prevent recurrences, preventive antibiotic therapy is administered for at least three years after an initial occurrence.

Rheumatic fever occurs most frequently among the poor in large cities, perhaps because this segment of the population does not have access to health care and is not treated promptly for strep infections. Rheumatic fever is also common in developing countries without access to antibiotics.

Rheumatic fever can be difficult to diagnose because the signs and symptoms are diverse. In order to simplify diagnosis, rheumatic fever is indicated if a person has two major manifestations of rheumatic fever, or one major manifestation and two minor manifestations. In both cases, evidence of strep infection is also necessary.

Typical minor signs of rheumatic fever include fever, joint pain, prior history of rheumatic fever, and laboratory evidence of a hypersensitive immune response to strep bacteria.