Rheumatic Fever Symptoms

Quick Glance: Common Rheumatic Fever Symptoms

The common rheumatic fever symptoms are as follows:

• Fever

• Joint pain or swelling in the elbows, ankles, wrists and knees

• Joints may feel hot or tender

• Pain in one joint that passes to another joint

• Fatigue

• Chest pain

• Small and painless bumps beneath the skin

• A painless flat or slightly raised rash with a ragged edge

Symptoms of Rheumatic Fever That Should Not Be Ignored

Some critical rheumatic fever signs should not be ignored, as they may develop as a serious inflammatory reaction after untreated scarlet fever or strep throat. Some of these symptoms are as follows:

Why Do Rheumatic Fever Symptoms Occur?

Rheumatic fever occurs because of an abnormal immune response rather than a bacterial infection. It occurs after a few weeks of group A Streptococcus infection. In some patients, the immune system attacks healthy tissues because some proteins in bacteria resemble proteins found in the body's own cells. This process is called molecular mimicry and causes inflammation.

Here are the organs and body systems affected by rheumatic fever:

• Joints: Inflammation of the joint lining causes pain, swelling, warmth, and redness. The inflammation tends to move from one large joint to another.

• Heart: Inflammation affects the heart muscle, lining, and valves. This condition is called carditis and may cause chest pain, breathlessness, palpitations, or long-term valve damage.

• Brain: Inflammation of the basal ganglia, a brain area involved in movement regulation, can cause involuntary movements called Sydenham chorea.

• Skin: Inflammatory changes can cause a characteristic ring-shaped rash (erythema marginatum) or painless nodules under the skin.

Symptoms of Rheumatic Fever That Require Immediate Medical Attention

Individuals with recent or suspected rheumatic fever should seek urgent medical care. The following symptoms indicate emergency medical attention:

• Severe chest pain, marked shortness of breath

• Fainting or a very fast/irregular heartbeat

• Sudden swelling of the legs, abdomen or face

• Difficulty breathing when lying flat

• Rapidly worsening jerky movements

• Inability to walk or feed

• Extreme behaviour changes.

• High, persistent fever

• Very painful, hot, swollen joints

• Any combination of the above in a child or teenager within weeks of a sore throat or scarlet fever.

Symptoms of Rheumatic Fever in Children

Rheumatic fever symptoms start appearing in a child after a few weeks of being infected with the Group A Streptococcus bacteria. Symptoms in every child may vary. However, some common symptoms include:

• Fever

• Lack of energy (fatigue)

• Joint inflammation across the knees or ankles with redness, swelling, and soreness

• Small, painless, hard bumps (nodules) under the skin

• Unusual jerky movements, most often of the hands and face. This sign is reflected by a change in a child's handwriting.

• Red rash with odd edges on the torso, arms or legs

• Weight loss

• Stomach pains

Any child with these early signs should be immediately assessed by a doctor as soon as possible.

Can You Have Rheumatic Fever Without Symptoms?

Yes, there can be mild cases of rheumatic fever with few signs, but a completely symptom-free rheumatic fever is rare. Mild carditis may cause no symptoms and may only be detected by clinical examination or echocardiogram. This is sometimes called subclinical carditis.

Rheumatic heart disease may also be diagnosed incidentally, during a routine examination or an examination for other illnesses. This is why doctors recommend follow-up after a Group A Streptococcus throat infection, especially in common target areas of rheumatic fever.

When Can Rheumatic Fever Symptoms Become Life-Threatening?

Rheumatic fever becomes life-threatening mainly when it causes severe inflammation of the heart or permanent valve damage. The table below shows the complications when rheumatic fever becomes dangerous and needs urgent medical attention:

How are Rheumatic Fever Symptoms Diagnosed?

No single test can confirm rheumatic fever. A healthcare provider can check your symptoms and ask about recent medical conditions, especially whether you have had a sore throat caused by Group A Streptococcus recently. They may perform a physical examination to confirm the diagnosis.

Here are some tests recommended to diagnose rheumatic fever:

Doctors can also use the Jones criteria (a recognised diagnostic framework) along with the tests mentioned in the table to diagnose rheumatic fever.