Rheumatic Fever (Acute Rheumatic Fever or ARF)

  • Medical Author:
    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What are the complications of rheumatic fever?

Most significant of the complications are cardiac in nature. Patients with rheumatic fever who develop carditis may develop long-lasting heart dysfunction. Often the mitral valve or the aortic valve is affected, and if patients are not responsive to medications, surgical valve replacement may become necessary. Atrial fibrillation (irregular fast heart rate) and heart failure can occur. Sydenham's chorea can be the most difficult complication to treat, and the individuals with this complication may get recurrence of the disease. A few people remain very susceptible to reinfection with GABHS and may require lifetime antibiotic treatment.

How is rheumatic fever prevented?

Prevention of rheumatic fever requires the recognition and diagnosis of group A strep throat infections and appropriate antibiotic therapy. In children 5-15 years of age, strep throat infections are very common and present as a sudden onset of throat pain, fever, headache, and abdominal pain. Most providers recognize these symptoms and test for the infection either with a rapid strep test or throat culture. Of note: Most causes of sore throat are not bacterial but are viral and do not carry the risk of rheumatic fever and cannot be treated with antibiotics. In addition, once an individual develops rheumatic fever after a strep throat infection, that individual remains at risk for subsequent episodes of rheumatic fever during subsequent strep throat infections. These individuals may need to receive chronic long-term prophylaxis (preventive treatment) with antibiotics. Researchers continue to attempt development of a vaccine against GABHS, but currently no vaccine is available.

Medically Reviewed by a Doctor on 3/18/2016
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