Rheumatic Fever

Diagnosis

Diagnosis of rheumatic fever is based on a combination of medical history, a physical exam and results from specific tests. There is no single test that can confirm the condition. Instead, healthcare professionals use multiple tools to look for signs of infection, inflammation and heart involvement.

Tests often used to diagnose rheumatic fever include blood tests such as C-reactive protein and erythrocyte sedimentation rate, which show inflammation in the body. Additional blood tests check for antibodies related to a recent strep infection when the bacteria are no longer present in the throat or bloodstream.

An electrocardiogram records the electrical activity of the heart and helps identify irregular heart rhythms or signs of heart swelling. An echocardiogram uses sound waves to produce detailed images of the heart, showing its structure and how blood flows through it. These findings help determine whether the heart has been affected.

Treatment

Treatment for rheumatic fever focuses on eliminating the infection, reducing symptoms, controlling inflammation and preventing future episodes.

Medicines play a key role in management. Antibiotics such as penicillin are used to kill any remaining strep bacteria, and a second course is often prescribed to prevent recurrence. Long-term antibiotic therapy may be required for several years, especially for children or people who had heart inflammation during their illness.

Anti-inflammatory medicines such as aspirin or naproxen help relieve pain, fever and swelling. If symptoms are more severe or don’t improve, corticosteroids may be recommended. For people experiencing involuntary movements caused by Sydenham chorea, antiseizure medicines such as valproic acid or carbamazepine may help reduce these symptoms.

Regular medical follow-up is essential because heart damage from rheumatic fever can appear many years later. Informing healthcare professionals of any history of rheumatic fever helps guide long-term monitoring and care.