Rheumatic fever

Rheumatic fever is an autoimmune inflammatory reaction that follows a throat or skin infection with group A streptococcus bacteria. The immune response attacks healthy tissue rather than the germ itself, and it can inflame the joints, heart, skin and nervous system. It mostly affects children and adolescents, is uncommon in wealthier settings, and remains a major burden where overcrowding, poverty and limited health services prevail; genes may also raise susceptibility. Signs generally emerge between 1 and 5 weeks following the infection, among them fever, painful moving joint swelling, chest pain, breathlessness, jerky uncontrollable movements called chorea, skin nodules and a rash. Repeated attacks can scar the heart valves, causing permanent rheumatic heart disease that may show only years later. Treatment combines antibiotics, pain relief, anti-inflammatory steroids when needed and rest, with long-term antibiotic prevention against recurrence; most patients recover fully from the acute episode.

Seek emergency care for chest pain or pressure lasting more than a few minutes, sudden breathlessness, fainting, or weakness or numbness of the face, arm or leg. See a doctor soon for palpitations, swollen ankles, breathlessness on exertion or a blood pressure reading that stays high. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.