Rheumatic fever

Rheumatic fever is also known as acute rheumatic fever (ARF). It is an autoimmune condition that can follow an infection caused by group A Streptococcus. These bacteria are also called Streptococcus pyogenes, GAS or Strep A.

Strep A bacteria can cause infection in your throat. This is known as pharyngitis or strep throat. It can also cause other infections such as impetigo, cellulitis and scarlet fever.

Rheumatic fever can affect parts of your body such as the:

• heart
• joints
• brain
• skin

Rheumatic fever symptoms can appear from days to months after a Strep A infection.

Symptoms of rheumatic fever can vary between people. They can range from very mild to severe and may include:

• fever
• painful, swollen joints or arthritis
• chest pain

Less common signs include:

• jerky movements of your hands, legs, tongue and face
• lumps on your elbows, wrists, knees, ankles and spine
• a rash on your skin, such as your chest, arms and legs

Rheumatic fever is caused by your body's immune response to the Strep A infection.

Sometimes, your immune system can get confused by an infection and mistakenly attack your body. This is called an autoimmune reaction. This reaction to Step A infection causes inflammation, which causes the symptoms of rheumatic fever.

You may be at an increased risk of rheumatic fever if you are:

• an Australian Aboriginal and/or Torres Strait Islander person
• a New Zealand Māori or Pacific Islander
• a child aged 5 to 14 years
• female

You are also more likely to get rheumatic fever if you:

• have had it before
• live in a rural or remote location
• live in crowded housing

Strep A can spread through respiratory droplets (when someone coughs or sneezes), or in contaminated food.

See your doctor if you are sick and have:

• a sore throat
• a skin infection
• fever and sore joints

Your doctor will talk with you about your symptoms and will examine you. They may arrange tests, like:

• blood tests
• a throat swab
• an echocardiogram

These tests can help your doctor find out if you are likely to have rheumatic fever.

There is no single test used to diagnose rheumatic fever.

If you are at higher risk of having rheumatic fever and you have symptoms of rheumatic fever, see your doctor.

If your doctor thinks you have rheumatic fever, you will usually be treated in hospital. In hospital, a team of healthcare professionals can look after you.

Your treatment will include:

• monitoring, such as with blood tests and imaging
• antibiotics for the Strep A infection
• rest

Medicine can also help with the symptoms. You may be given medicines such as paracetamol for pain relief and to reduce your fever. Your doctor may also recommend medicines to reduce inflammation in your joints. You may also be given medicine to reduce any jerky movements you're having.

Long-term treatment may include antibiotics. This can help prevent future Strep A infection and prevent complications.

The main complication of rheumatic fever is rheumatic heart disease (RHD).

RHD is when your heart valves are damaged due to the inflammation caused by rheumatic fever. It can cause complications such as:

• breathing difficulties
• fatigue
• heart failure
• atrial fibrillation
• pulmonary hypertension
• stroke

Good hygiene practices can help prevent Strep A infection. This can include:

• covering your mouth when you cough or sneeze, such as by using a tissue
• not sharing eating utensils or towels with others
• washing your hands well before preparing food

You can help prevent rheumatic fever by seeing the doctor or nurse when you're sick.

If you have a Strep A infection, it's important to avoid spreading it to others. Stay away from other people as much as you can.

The Heart Foundation (Opens in new tab) website has information on acute rheumatic fever and rheumatic heart disease (Opens in new tab).

Languages other than English

The Sydney Children's Hospital Network has a fact sheet on Strep A bacteria (Opens in new tab) in Arabic (Opens in new tab), Hindi (Opens in new tab), Vietnamese (Opens in new tab), Chinese (Opens in new tab) and Korean (Opens in new tab).

Information for Aboriginal and/or Torres Strait Islander peoples

Australian Indigenous HealthInfoNet (Opens in new tab) has information about ARF and rheumatic heart disease (Opens in new tab).

The END RHD website (Opens in new tab) has information (Opens in new tab) on rheumatic heart disease for Aboriginal and/or Torres Strait Islander peoples.

You can read about the Northern Territory Rheumatic Heart Disease Program (Opens in new tab). This includes resources for patients and families.

You can call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.