Rheumatic fever

Diagnosis

There's no single test for rheumatic fever. Diagnosis of rheumatic fever is based on medical history, a physical exam and certain test results.

Tests

Tests for rheumatic fever include:

• Blood tests. Blood tests can be done to check for signs of inflammation in the body. These tests include C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR), also called the sed rate.

  Sometimes the actual strep bacteria is no longer be found in the blood or in throat tissues. Another blood test can be done to look for proteins related to the strep bacteria. These proteins are called antibodies.

• Electrocardiogram (ECG or EKG). This test shows how the heart is beating. It can help diagnose irregular heartbeats. A healthcare professional can check ECG signal patterns for signs of heart swelling.
• Echocardiogram. Sound waves are used to create pictures of the heart in motion. An echocardiogram shows the structure of the heart and how blood flows through it.

Treatment

The goals of treatment for rheumatic fever are to:

• Treat the infection.
• Ease symptoms.
• Control swelling, called inflammation.
• Prevent the condition from returning.

Medicines

Rheumatic fever is treated with medicines, including:

• Antibiotics. Penicillin or another antibiotic is usually given to kill the strep bacteria.

  After the first antibiotic treatment is fully finished, another round of antibiotics may be given. This stops the rheumatic fever from coming back. A child might need to continue taking antibiotics for 5 years or through age 21 to prevent rheumatic fever from coming back, whichever is longer.

  People who had heart inflammation during rheumatic fever might need to continue antibiotics for 10 years or longer.

• Anti-inflammatory drugs. Aspirin or naproxen (Naprosyn, Naprelan, Anaprox DS) can help reduce inflammation, fever and pain. If symptoms are severe or don't improve with anti-inflammatory medicines, a corticosteroid might be prescribed. Don't give a child aspirin unless a healthcare professional tells you to do so.
• Antiseizure drugs. Medicines such as valproic acid or carbamazepine (Carbatrol, Tegretol, others) may be used to treat severe involuntary movements caused by Sydenham chorea.

It's important to have regular health checkups after having rheumatic fever. Heart damage from rheumatic fever might not show up for many years — even decades. Always tell your healthcare provider about any history of rheumatic fever.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

A healthcare provider might recommend bed rest for someone with rheumatic fever. There may be activity restrictions until symptoms improve.

Preparing for your appointment

Make an appointment for a health checkup if symptoms of rheumatic fever develop. If there is heart damage, you may be sent to a doctor trained in heart diseases, called a cardiologist.

Here's some information to help you get ready for the appointment.

What you can do

When you make the appointment, ask if any special preparations are needed. For example, you may not be able to eat or drink for a while before some blood tests. Make a list of:

• The symptoms, including any that seem unrelated to the reason for the appointment.
• Important personal information, including major stresses, recent life changes and family medical history.
• All medicines, vitamins or other supplements being taken. Include the doses.
• Questions to ask the healthcare team.

For rheumatic fever, basic questions to ask the care team include:

• What are the possible causes of the symptoms?
• What tests are needed?
• What treatment is needed?
• What are the options to the main treatment that you're suggesting?
• My child or I have other health conditions. How can we best manage them together?
• Are there activity or diet restrictions?
• Should we see a specialist?
• Are there brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

The healthcare team is likely to ask questions, such as:

• When did the symptoms begin?
• What, if anything, seems to improve the symptoms?
• What, if anything, appears to make the symptoms worse?
• Do the symptoms happen all the time or do they come and go?
• Has anyone in your family been sick with a cold or flu lately?
• Is there a history of strep throat or scarlet fever?
• If so, were all antibiotics taken as prescribed?