Rheumatic Fever – Symptoms, Tests, Criteria, Treatment

Rheumatic fever is an inflammatory disease that is developed due to an infection caused with streptococcus bacteria. The infection is usually known as scarlet fever or strep throat. The joints, heart, brain and skin can be affected by this disease. There are many causes and risk factors of rheumatic fever.

This fever is common worldwide and it is responsible for damaging many heart valves. It is very uncommon in the United States. The occurrence is usually found in the isolated outbreaks. The latest outbreak was found in 1980’s. Usually the children aged between 6 and 15 are affected by rheumatic fever. The occurrence of this fever is usually found 20 days after scarlet fever and strep throat.

Symptoms of rheumatic fever include fever, abdominal pain, heart problems, joint pain, arthritis mainly in elbows, knees, wrists and ankles, joint swellings, warmth or redness, nosebleeds, skin nodules, skin rashes, Sydenham chorea etc.  The heart problems may not have any specific symptoms. Sometimes it may result into chest pain and shortness of breath.  A person may experience skin eruption on the trunk as well as on the upper part of the legs and arms. The eruption may look snake-like or ring-shaped. Sydenham chorea leads to muscle weakness, emotional instability, uncoordinated jerky movements that affect the feet, face and hands.

Different forms are found in this disease. Hence, a single test cannot firmly diagnose this disease. A careful exam maybe performed by the doctor who includes checking the heart, joints and skin.

The test may include:

  • Blood test if strep infection is recurrent. ASO test is a common test.
  • Electrocardiogram
  • Complete blood count
  • Sedimentation rate

Several minor and major criteria have been developed for standardizing the rheumatic fever diagnosis. If these criteria are met along with the evidence of streptococcal infection, the case of rheumatic fever can be confirmed.

The major criteria for diagnosing the fever include:

  • Joint pain or arthritis in joints
  • Heart inflammation
  • Jerky and rapid movements
  • Nodules under the skin
  • Rashes on skin

The minor criteria for diagnosing fever include:

  • High ESR
  • Fever
  • Joint Pain

The treatments for rheumatic fever vary. Antibiotics are used for treating acute rheumatic fever. Anti-inflammatory medications such as corticosteroids or aspirin can help in reducing the inflammation as well as managing acute rheumatic fever. One can also take low doses of antibiotics such as sulfa diazine, erithromycine and penicillin.