The symptoms of rheumatic fever usually develop one to five weeks after a streptococcal throat infection.
Common symptoms
Common symptoms of rheumatic fever are described below.
Arthritis
Pain and swelling of the joints (arthritis) is the most common symptom affecting 3 out of 4 people.
The larger joints, such as the knees, ankles, elbows and wrists are usually affected; typically on both sides of the body. Multiple joints are normally affected at the same time.
The symptoms of arthritis should pass within four weeks without causing any permanent damage.
Inflammation of the heart (carditis)
Inflammation of the heart (carditis) is another common and potentially serious symptom of rheumatic fever.
Carditis is thought to occur in an estimated 30-60% of cases and is most common in younger children.
Due to the inflammation, the heart has difficulties pumping blood around the body which can cause the following symptoms:
- shortness of breath, especially when a person is physically active or when sleeping (this can often wake a person up gasping for breath)
- persistent cough
- rapid heartbeat
- feeling tired all the time
- chest pain
Carditis can persist for several months but it should improve over time.
Sydenham chorea
Sydenham chorea is a term used to describe a collection of symptoms related to inflammation of the nerves. These symptoms are:
- involuntary and incontrollable jerking and twitching of the body; most often the hands and feet
- difficulties with tasks requiring fine hand movements, such as writing
- difficulties with balance
- unusual emotional outbursts such as crying or laughing for no apparent reasons
Around in 1 in 4 children with rheumatic fever will develop Sydenham chorea, but it is very rare in adults.
Sydenham chorea usually passes within a few months and should not cause any permanent damage to the nervous system. Although there have been a number of reports of it persisting for up to 1-2 years.
Skin rash
Around 1 in 10 children with rheumatic fever will develop a skin rash. The rash is usually painless, non-itchy and spreads slowly over the child’s body. It may only be noticeable in fair-skinned children.
The rash will normally come and go over the course of a few weeks or months, before going away all together.
It is very rare for adults with rheumatic fever to get a skin rash.
Less common symptoms
Less common symptoms of rheumatic fever include:
- small painless bumps or lumps develop under the skin
- a very high temperature (fever) of or above 39°C (102°F)
- abdominal pain
- nosebleeds
