The link between scarlet fever and rheumatic fever

Rheumatic fever is a disease that affects your brain, heart, joints, and skin.
This fever can develop if scarlatina, commonly known as scarlet fever, is not treated early and properly.
The early detection of scarlet fever’s symptoms and a correct diagnosis are the keys to preventing rheumatic fever.What are scarlet fever and rheumatic fever?
What is scarlet fever?
Scarlet fever usually occurs when you already have strep throat and are then infected with a bacterial illness.
Scarlet fever features a bright red rash that covers most of the body. A sore throat and a fever almost always accompany scarlet fever.
What is rheumatic fever?
Rheumatic fever is an inflammatory disease that develops if your strep throat or scarlet fever aren’t properly treated. It’s a serious illness that usually appears in children between the ages of 5 and 15. It has also been seen in older children and even adults.
Symptoms of scarlet fever and rheumatic fever
Illness usually begins with a sore throat and a fever above 101 degrees Fahrenheit.
Abdominal pain, chills, and vomiting might also occur. Within a couple of days a red rash typically appears on your neck, underarm, or groin. The rash begins as small, flat blotches that slowly become fine bumps. Over time, it can spread all over your body.
Symptoms of rheumatic fever
Rheumatic fever symptoms can vary in type and severity. They may also change during the course of your illness.
The onset of rheumatic fever usually occurs a few weeks after your strep throat infection. Rheumatic fever signs and symptoms can include:
- Chest pain
- Fatigue
- Fever
- Heart murmurs
- Flat or slightly raised rashes
- Pain in the joints
- Pain in one joint that migrates to another joint
- Red, hot or swollen joints
- Small, painless bumps beneath the skin
There can also be behavioral symptoms brought on by rheumatic fever.
Jerky, uncontrollable body movements that occur in the hands, for example, is known as Sydenham chorea. This is sometimes accompanied by outbursts of unusual behavior, such as crying or inappropriate laughing.
Causes of scarlet fever and rheumatic fever
Causes of scarlet fever
A bacterium called group A streptococcus, or group A strep, causes scarlet fever. It releases a toxin that creates a reddish, or scarlet, rash on your skin.
Scarlet fever is more common among children, but it can develop at any age.
Causes of rheumatic fever
Rheumatic fever is caused by the same bacteria as scarlet fever. The link between strep infection and rheumatic isn’t entirely clear.
Doctors believe that the strep bacteria fools your immune system. Streptococcus has a similar protein that is found in certain tissues of your body.
Your body's immune system responds to a strep infection by attacking its own tissue, particularly your heart, joints, skin, and central nervous system. Your immune system reaction results in an inflammation of those tissues.
Diagnosis for scarlet fever and rheumatic fever
Only a licensed healthcare professional can diagnose scarlet or rheumatic fever.
Scarlet fever diagnosis
Your doctor can usually diagnose scarlet fever by asking you questions about how you’re feeling and where there might be pain. They will perform a physical exam to look for signs and symptoms of scarlet fever.
A throat culture can help determine if and what kind of bacteria are present.
Rheumatic fever diagnosis
Your doctor will want to know if you have experienced symptoms or signs of strep or scarlet fever. They will perform similar tests to determine those conditions, as this is what causes the onset of rheumatic fever.
Your doctor will also perform several physical examinations. These may include looking at your skin for rashes, listening to your heart for abnormalities, and examining your joints for inflammation.
Treatments for scarlet fever and rheumatic fever
Scarlet fever treatment
If your doctor determines that you have scarlet fever, they will prescribe antibiotics for you to take.
Amoxicillin or penicillin are recommended for people who aren’t allergic to them. There are alternative medicines like erythromycin for those who are allergic.
Your doctor will also recommend that you rest and drink plenty of liquids. Additionally, you should not go near others while sick, as scarlet fever is highly contagious.
Rheumatic fever treatment
Your doctors will typically treat rheumatic fever with aspirin to reduce fever, pain, and general inflammation. They will also prescribe antibiotics similar to those for scarlet fever to tackle the root of the problem.
People who develop rheumatic heart disease with symptoms of heart failure may require additional medicines to help manage those conditions as well.

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Centers for Disease Control and Prevention: "Rheumatic Fever."
Centers for Disease Control and Prevention: "Scarlet Fever."
Merck Manual, Professional Edition: "Rheumatic Fever."
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