1. The First Step Is a Streptococcus Infection
Not everyone who gets strep throat ends up with rheumatic fever, but everyone who gets rheumatic fever has been infected with group A streptococcus. It's the main culprit behind this disease, which may eventually damage the heart, spine, brain or cause other health problems. The most common of these is rheumatic heart disease. The strep infection is the first step in contracting rheumatic fever; the other signs and symptoms don't show up until a few weeks after the initial strep infection.
2. Major Criteria for Diagnosing Rheumatic Fever
There's no specific test that will reveal if you have rheumatic fever. The diagnosis is made by a doctor's examination, and in addition to having strep throat recently, you must have two of the major criteria or one major and two minor criteria. Some of the major criteria are arthritis symptoms in some joints, a skin rash, nodules under the skin, chest pain or inflammation of the heart, jerky movements of the body (known as chorea or Syndenham's chorea), abdominal pain or vomiting and fatigue. You aren't likely to develop these symptoms until a few weeks after having the strep infection.
3. Minor Criteria for Diagnosing Rheumatic Fever
Certain symptoms may also contribute to a diagnosis of rheumatic fever--joint pain, a fever and a high ESR (erythrocyte sedimentation rate)--in that same couple weeks after you have strep throat. ESR, usually just called a "sed rate," is a blood test that checks for inflammation. It isn't very specific, so it's not generally useful all by itself. But it adds to the evidence that that some type of arthritic process is occurring.
4. Rheumatic Fever is a Childhood Disease
Adults rarely come down with rheumatic fever. Mostly it's found in children between the ages of five and 15. Rheumatic fever is uncommon in the U.S. but still common in developing countries. But no matter where you live, it may be a good idea to find out if this specific type of strep is causing your child's sore throat, because that information is important in making the diagnosis of rheumatic fever.
5. Be Aware of Further Complications
If you've had rheumatic fever, you are susceptible to rheumatic heart disease, the most common long-term result, though joint and skin problems, chorea, and even a tic or symptoms that mimic obsessive-compulsive disorder might become issues. The likelihood of ending up with one or more of the effects increases with if you've had more than one bout of rheumatic fever, especially if it isn't treated properly. So if you or one of your children ever gets rheumatic fever, be sure to take care of it immediately and fully. This means you absolutely must completely use up the prescribed dosage of antibiotics; you can't stop taking them just because your symptoms have disappeared.
