What are the long-term effects of rheumatic fever?

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Rheumatic fever occurs due to immune system changes in response to strep throat and other infections caused by Group A Strep. Usually, this happens when a person has not received proper treatment for the infection.

Symptoms of rheumatic fever include inflammation of the heart, joints, brain, and skin. This happens because the immune system mistakes these areas for an infection and attacks them.

Generally, rheumatic fever symptoms include:

• fever
• arthritis or tender joints, especially in the knees, ankles, elbows, and wrists
• chest pain
• shortness of breath
• fatigue
• jerky body movements
• heart murmur
• enlarged heart
• fluid surrounding the heart

Typically, people start to develop rheumatic fever symptoms 1–5 weeks after a strep A infection. Rheumatic fever is not contagious because the symptoms result from immune system changes. However, bacteria can spread strep A infections, which can trigger rheumatic fever.

Learn more about rheumatic fever.

Most complications related to rheumatic fever involve the cardiovascular system, in particular, rheumatic heart disease (RHD).

RHD increases the risk of several cardiovascular conditions, such as:

• inflammation of heart tissue, particularly inside the heart chambers
• stroke or heart attack
• heart failure
• pulmonary hypertension
• atrial fibrillation
• heart valve disease

Jaccoud arthropathy is another complication that causes changes in the joints, particularly in the hands and feet. People with this condition have a higher risk of dislocation. Jaccoud arthropathy tends to develop after a person experiences repeated episodes of arthritis, which can be a complication of rheumatic fever.

While much rarer, a strep A infection can trigger Sydenham chorea. This is a brain condition that affects the basal ganglia. The basal ganglia are deep within the brain and control movement.

When rheumatic fever affects this part of the brain, a person may begin to jerk or have difficulty moving. Sometimes, a complication of Sydenham chorea can lead to long-term mobility difficulties.

Read more about rheumatic heart disease.

Treatment for rheumatic fever is similar to treatment for other types of fever. This includes medications that reduce pain and fever. A person should also receive antibiotics as a precaution for an active infection.

Where rheumatic fever has progressed and caused long-term heart disease, a person may require cardiovascular medications and surgery.

Learn more about fevers and how to treat them.

To prevent rheumatic fever from causing complications, a person needs treatment with antibiotics for any underlying strep infections. This is in addition to any medications that reduce fever and pain. Usually, healthcare professionals treat rheumatic fever in a hospital environment.

Once a person has recovered from rheumatic fever, they may need prophylactic, or preventive, treatment to help prevent it from returning. These treatments include preventive antibiotics.

Children or adolescents may need to take these monthly until they are 21 years old. Preventive antibiotics reduce the risk of developing a strep infection and rheumatic fever.

Learn more about antibiotics.

Several risk factors can increase the risk of rheumatic fever, including:

• not finishing a course of antibiotics for a sore throat (streptococcal pharyngitis)
• a history of rheumatic fever
• a history of repeated strep infections
• being in areas with many people, such as schools and day care centers

Children ages 5–15 years are the most likely to get rheumatic fever. Adults rarely develop rheumatic fever for the first time.

Learn if there are any similarities between rheumatoid arthritis and rheumatic fever.

The following are some questions people frequently ask about rheumatic fever.

Can you fully recover from rheumatic fever?

A person can fully recover from rheumatic fever. However, people who have had rheumatic fever are more likely to develop complications from it again if a strep infection and fever are left untreated. Prompt treatment for any strep infection is essential.

What is the most common complication of rheumatic fever?

Rheumatic heart disease (RHD) is the most common complication of rheumatic fever. RHD is a very severe form of heart disease, especially in young children.

If a child experiences rheumatic fever on multiple occasions, the heart valves can thicken or scar. This has a significant effect on the cardiovascular system and can leave a child vulnerable to developing stroke or pulmonary hypertension in later life.

Can rheumatic fever cause permanent damage?

Rheumatic fever can cause permanent damage if left untreated. During an episode of rheumatic fever, the immune system can cause inflammation in the heart, joints, brain, and skin. If this inflammation is left untreated for an extended period, it could result in permanent damage. This is especially important to prevent RHD.

The long-term effects of rheumatic fever mainly affect the heart and joints. When a person develops a heart condition after rheumatic fever, this is known as RHD, a serious cardiovascular diseaase. RHD can increase a person’s risk of stroke, pulmonary hypertension, and heart failure.

Treating the underlying strep infection and controlling fever symptoms can help prevent long-term complications from rheumatic fever. A doctor may prescribe preventive antibiotics to prevent strep infections and rheumatic fever from returning.

Rheumatic fever can also cause other long-term conditions, including Jaccoud arthropathy, which tends to affect the joints in the hands and feet.