Rheumatic Fever – What You Need to Know

If you or a child had a sore throat that seemed to get worse instead of better, chances are you heard the term “rheumatic fever.” It’s not a common illness, but when it shows up it can affect the heart, joints, and brain. The good news is that early treatment stops most problems, so knowing the signs and what triggers it can save a lot of trouble.

Rheumatic fever starts after an infection with group A Streptococcus – the same bug that causes strep throat. Most people recover from a sore throat without any issue, but in some cases the immune system goes overboard. It attacks the body’s own tissues, especially the heart valves and joints. That’s why you might feel joint pain or notice a new heart murmur weeks after the throat infection cleared up.

The classic symptoms show up 2‑4 weeks after the sore throat. Look out for fever that won’t go away, painful swollen knees or ankles, tiny painless spots under the skin (called erythema marginatum), and jerky movements called chorea. Not everyone gets all of these, but any combination should raise a red flag.

Doctors confirm rheumatic fever with a set of criteria that mix symptoms, lab tests, and evidence of a recent strep infection. They’ll check for elevated inflammation markers like ESR or CRP, do an ECG to see if the heart is affected, and may swab the throat or look for antibodies that prove a recent strep bug.

What Causes Rheumatic Fever?

The root cause is the immune response to streptococcal bacteria. When the body fights the infection, it creates antibodies that sometimes mistake heart tissue for bacterial proteins – a case of mistaken identity. This cross‑reaction damages the lining of the heart (the endocardium) and can scar the valves over time.

Risk factors include being under 20 years old, not treating strep throat promptly with antibiotics, and having a family history of rheumatic fever. In many parts of the world where healthcare access is limited, the disease is still more common because people don’t get proper treatment for sore throats.

How It’s Treated and Prevented

The first step in treatment is a short course of antibiotics to kill any lingering streptococci. Penicillin is usually the go‑to drug, but alternatives exist for those allergic to it. Alongside antibiotics, doctors prescribe anti‑inflammatory meds – either aspirin or steroids – to calm joint pain and reduce heart inflammation.

Long‑term care often means staying on a low dose of penicillin for several years to stop the disease from coming back. Regular check‑ups with a cardiologist are crucial because valve damage can appear slowly, sometimes decades after the original episode.

Prevention is mostly about treating strep throat quickly and correctly. If you have a sore throat that’s painful, has white patches, or comes with fever, see a doctor and get tested. A simple 10‑day antibiotic course can keep rheumatic fever off your radar.

In short, rheumatic fever is a preventable complication of strep throat. Spot the early signs, act fast with antibiotics, and follow up with your doctor to protect your heart for life.