Untreated or inadequately treated streptococcal throat infections, particularly strep throat, can result in rheumatic fever, a serious inflammatory condition. Here is a look at the causes, symptoms, diagnosis, treatment, and prevention of rheumatic fever. It mainly affects children and adolescents. If not diagnosed and treated promptly, it can cause long-term complications.
Infections with group A Streptococcus bacteria, which cause strep throat, cause rheumatic fever, which is caused by an abnormal immune response. Consequently, inflammation and tissue damage occur in the body when the immune system mistakenly attacks healthy tissues, including the heart, joints, skin, and brain. Genetic factors may play a role in susceptibility to rheumatic fever, and not all individuals with strep throat develop it.
The symptoms of rheumatic fever may vary in severity and can affect multiple organs and systems in the body.
The fever
Knee, ankle, elbow, and wrist pain and swelling
Small, painless red or pink spots on the skin
Weakness and fatigue
Pain or discomfort in the chest
Heart palpitations (rapid or irregular heartbeat)
Breathing difficulties
Movements or jerking motions in the arms, legs, or face that are abnormal, known as Sydenham's chorea
Rheumatic fever is diagnosed through a combination of medical history, physical examination, laboratory tests, and imaging studies.
Streptococcal infection, confirmed by throat culture or rapid strep test
The Jones criteria specify two major criteria or one major criterion and two minor criteria
The most common criteria are carditis (inflammation of the heart), arthritis (inflammation of the joints), rash, Sydenham's chorea, and subcutaneous nodules.
Fevers, arthralgia (joint pain), elevated acute phase reactants (such as C-reactive protein or erythrocyte sedimentation rate), and prolonged PR interval on an electrocardiogram (ECG) are minor criteria.
Rheumatic fever treatment aims to reduce inflammation, manage symptoms, and prevent complications. Treatment options include:
To eradicate streptococcal bacteria and prevent recurrence, antibiotics such as penicillin or amoxicillin are typically prescribed.
Pain, inflammation, and fever associated with rheumatic fever may be reduced with nonsteroidal anti-inflammatory drugs (NSAIDs).
When rheumatic fever is severe, corticosteroids may be prescribed to reduce inflammation and prevent complications, particularly if the heart is affected.
A bed rest and avoidance of strenuous physical activity may be recommended during the acute phase of rheumatic fever to reduce strain on the heart and joints.
It is important to diagnose and treat streptococcal throat infections promptly with appropriate antibiotics in order to prevent rheumatic fever. Other preventive measures include:
Children and adolescents at risk for rheumatic fever should be treated for strep throat as soon as possible
Informing patients, caregivers, and healthcare providers about the signs and symptoms of strep throat and rheumatic fever
Practice good hand hygiene, cover coughs and sneezes, and avoid close contact with sick individuals to prevent streptococcal infections
