Rheumatic Fever

If your child has had a sore throat for more than a couple of days, reach out to their healthcare provider. Treating a group A streptococcal infection can prevent rheumatic fever.

If their provider suspects rheumatic fever, they’ll first swab your child’s throat to check for group A Streptococcus bacteria. They may use a rapid strep test or order a throat culture.

A rapid strep test can provide results within 10 minutes. A throat culture takes a few days to get results. However, rapid strep tests sometimes give false-negative results (saying you don’t have strep when you really do).

What other tests will be done to diagnose rheumatic fever?

Depending on your symptoms, your child’s healthcare provider may also order:

• Blood tests: Sometimes, providers order a blood test to confirm a strep infection. Blood tests can detect antibodies (your body’s defenses against the bacteria) when the bacteria no longer show up on tests. Other blood tests check for substances (like proteins) that show inflammation in your child’s body.
• Heart tests: Heart tests help providers check your child’s heart function. These may include an electrocardiogram (EKG) or an echocardiogram (ultrasound of the heart, also known as an echo).

What are the Jones criteria for rheumatic fever?

Healthcare providers sometimes use the Jones criteria to diagnose rheumatic fever. To make a diagnosis of rheumatic fever, your child must have two major criteria or one major and two minor criteria from the following lists. In addition, there must be laboratory evidence of a previous group A streptococcal infection.

Major criteria include:

• Arthritis of several joints.
• Heart inflammation (carditis).
• Bumps (nodules) under their skin.
• Rapid, jerky movements (chorea).
• Skin rash (erythema marginatum).

Minor criteria include:

• Fever.
• Elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) levels.
• Joint pain (arthralgia).
• EKG (electrocardiogram) changes.
• History of previous rheumatic fever or rheumatic heart disease.