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.


Pain and swelling of the joints (arthritis) is the most common symptom of rheumatic fever, affecting three out of four people.

The larger joints, such as the knees, ankles, elbows and wrists are usually affected, typically on both sides of the body. Several joints are usually affected at the same time.

The symptoms of arthritis should pass within four to six weeks as the inflammation settles, without causing any permanent damage.

Heart inflammation (carditis)

Inflammation of the heart (carditis) is another common and potentially serious symptom of rheumatic fever.

Carditis occurs in an estimated 30-60% of people with rheumatic fever and is more common in younger children.

As a result of the inflammation, the heart has difficulty pumping blood around the body, which can cause the following symptoms:

Carditis can persist for several months, but it should improve over time.

Sydenham's chorea

Sydenham's chorea is a term that describes a collection of symptoms related to inflammation of the nerves. These symptoms are:

  • involuntary and uncontrollable jerking and twitching of the body – most often, the hands and feet
  • difficulty with tasks requiring fine hand movements, such as writing
  • problems with balance
  • unusual emotional outbursts, such as crying or laughing for no apparent reason

Around in one in four children with rheumatic fever will develop Sydenham's chorea, but it is rare in adults.

Sydenham's chorea usually passes within a few months, although in some cases it can persist for up to two years. It shouldn't cause any permanent damage to the nervous system.

Skin rash

Around 1 in 10 children with rheumatic fever will develop a skin rash, known as erythema marginatum. The rash is usually painless, non-itchy and spreads slowly over the child's body. It may only be noticeable in children with fair skin.

The rash usually comes and goes over the course of a few weeks or months, before disappearing altogether.

It's rare for adults with rheumatic fever to develop a skin rash.

Less common symptoms

Less common symptoms of rheumatic fever include:

  • subcutaneous skin nodules – small painless bumps or lumps under the skin, usually found on the wrists, elbows and knees
  • a high temperature (fever) of 39C (102F) or above
  • abdominal pain
  • nosebleeds

Page last reviewed: 29/10/2015
Next review due: 31/03/2018