Rheumatic Fever in Children

Rheumatic Fever

Rheumatic fever is a serious illness that usually afflicts children between the ages of 5 and 15 years. This disease usually develops after a particular case of a sore throat and can affect the heart of the child.


What is Rheumatic Fever?

Rheumatic fever is an inflammatory disease that is usually caused by the improper treatment of any condition caused by the Streptococcus bacteria such as scarlet fever or strep throat. It develops between two to four weeks after the initial infection and affects the joints, skin, heart and even the brain.

Causes of Rheumatic Fever in Kids

  • One of the main causes is the occurrence of an infection caused by Streptococcus bacteria such as scarlet fever, impetigo, cellulitis, and strep throat. While the bacteria do not cause the fever, they spark off an autoimmune response by the body that is called rheumatic fever. The body targets cells in the central nervous system, heart, joints, and skin.
  • Some studies have shown a correlation between genetics and the occurrence of this fever.
  • Environmental factors such as poor sanitation, unhygienic surroundings, and lack of access to healthcare are also factors that contribute to the development of rheumatic fever.

Who is at Risk of Rheumatic Fever?

This fever most commonly afflicts children between the ages of 5 and 15 years. The biggest risk factor of rheumatic fever is the occurrence of strep throat and infection that causes pain and inflammation in the throat. Other conditions include pyoderma which is a skin condition.

child having throat infection

Rheumatic Fever Symptoms in Children

The symptoms of rheumatic fever in children can be hard to pin down as they will change over the course of the illness. Depending on the individual illness, all the symptoms or just a few will be observed. Some of the symptoms that you might observe include:

  • Fever of more than 101 degrees – If your child has a consistent fever with a temperature over 101 degrees Fahrenheit, it could be a symptom of the ailment. It is recommended that you seek medical help immediately if the fever persists beyond an afternoon or at most a day.
  • A sore throat with or without swollen lymph nodes – Rheumatic fever is commonly accompanied by a sore throat. This can include the lymph nodes being swollen as well, a sore throat alone, however, is not a sign of this condition and has to be accompanied by a high fever and at least one more symptom.
  • Headache – A mild to a severe headache combined with the fever can indicate a rheumatic fever. This, however, is not conclusive.
  • Nausea – While this symptom can be confused with a gastric condition, if it accompanies a sore throat, then you must get your child tested.
  • Vomiting – be sure to administer oral rehydration while you wait for a doctor’s attention.
  • Nosebleeds – this symptom is not too common and occurs rarely.
  • Pain in the joints particularly the knees, elbows, wrists, and ankles; the characteristic property of this pain is that it migrates from one to other points in the body.
  • Bumps below the skin – usually they are painless.
  • Pain in the chest – this usually indicates that the heart has been affected by the fever.
  • Heart murmur – more often than not, one or more valves of the heart are affected by rheumatic fever, and can cause arrhythmia, or heart murmurs.
  • Fatigue that is a result of all the joint pain and other aches in the body.
  • Jerky movements that are uncontrollable.
  • Unusual behaviour such as laughing or crying at inappropriate moments caused usually by the fever getting to the head.

How Diagnosis is Done

When you take your child to his paediatrician, the first thing she will make note of is your child’s medical history. She will also check to see if your child has had a recent bout of strep throat. Apart from this, she will also conduct a physical examination that will include the following:

  • She will look out for any rashes on the body which will feel like hard bumps under the skin.
  • She will listen to the heart to check for any abnormalities.
  • She will also conduct a few movement tests to check the nervous system.
  • Checking for inflammation in the joints is also necessary.
  • There may be blood tests to see if there is a strep infection.
  • Electrocardiogram and echocardiogram are performed to check for any abnormalities in the heart.

doctor examine the child

Risks and Complications

Rheumatic fever can last for a long time going up to a few months and can have several long-term effects if not monitored closely. These complications include:

  • Rheumatic heart disease
  • Narrowing of a heart valve
  • A leak in a heart valve causing the blood to flow in the wrong direction
  • Heart muscle inflammation that causes the muscles of the heart to weaken
  • Irregular heartbeat
  • Heart failure
  • Sydenham chorea which is jerky uncontrollable movements of the muscle

Treatment for Rheumatic Fever

The treatment plan for rheumatic fever will mainly involve fighting the streptococcus bacterial infection and management of the symptoms.

1. Antibiotics

Antibiotics will be prescribed in order to fight the infections. Your doctor will also recommend a long-term treatment in order to ensure that the infection does not repeat again. This treatment can last up to five years.

2. Anti-inflammatory

One of the main symptoms of Rheumatic fever is inflammation of different parts of the body. Your child’s paediatrician will put your child on an anti-inflammatory treatment.

3. Anticonvulsants

If your child is experiencing uncontrollable jerky movements, then her doctor will prescribe anticonvulsants to control the movements.

4. Bed Rest

Your child will need extensive amounts of bed rest until the inflammation and other severe symptoms go away. If the heart is affected, then your child will need more bed rest in order to not tax the heart. This will be necessary for anywhere between a few weeks to a few months.

Is Rheumatic Fever Reversible?

The chances of your child developing the fever again are highest in the first three years of contracting it for the first time. However, with a treatment plan that involves the use of antibiotics for an extended period of time, your child should be able to fight the incidence of the disease.

With time, as your child grows older, the chances of the reoccurrence will decrease. Once your child is 18 years old, your child’s doctor might decide to stop the antibiotic treatment entirely.


The only way to avoid Rheumatic fever in your child is to ensure that any incidence of strep throat is fully and quickly treated. Be sure to get medical attention and schedule follow-up visits with your child’s doctor in order to determine if the infection has gone away fully. You must also make sure that the entire course of medications is taken.

In order to avoid incidences of strep throat, your child can follow the tips given below:

  • Teach your child the importance of covering their mouth and nose when sneezing or coughing. Rheumatic fever is not contagious, but strep throat is.
  • Your child must wash their hands regularly, especially before and after eating food.
  • If your child is sick, then do not send them to school. Conversely, do not let your child play or interact with other children who are sick.
  • Make sure that your sick child’s things are not shared with anyone else unless it has been washed and sterilised.

child washing her hands

Rheumatic fever can have severe implications on the health of your child’s body. Making sure that your child gets the adequate amount of medical attention is key to managing this condition. Follow the basic rules of hygiene in order to avoid a streptococcus-bacteria infection which is the precursor to the disease.