What is rheumatic fever?

Rheumatic fever is a rare but serious disease caused by untreated strep throat or scarlet fever. It is not common in the United States due to the widespread use of antibiotics to treat these conditions. The disease occurs more in the developing world, where infections by group A streptococcus may go undiagnosed and untreated.

Though rare, rheumatic fever does occur in the U.S., usually in areas with high levels of poverty and limited access to medical care.

Rheumatic fever can affect the heart, joints, nervous system, and skin. The most serious complication, rheumatic heart disease, can lead to heart inflammation and scarring of the valves.

Who gets rheumatic fever?

Rheumatic fever is most common in children between the ages of 5 and 14 in the developing world with limited access to medications and medical care to treat their strep throat or scarlet fever. Sometimes, the symptoms of strep are so mild that people do not realize they are infected until rheumatic fever develops.

Not everyone with untreated group A streptococcus gets rheumatic fever, however. It is more common in very young people, or those with already weakened immune systems. Some doctors and researchers also believe some families have a higher genetic susceptibility to rheumatic fever.

What causes rheumatic fever?

Rheumatic fever is caused by a strep throat or scarlet fever infection that is not treated with antibiotics. These are caused by the group A streptococcus bacteria. Rheumatic fever cannot be spread from person to person, though strep throat can be spread this way.

Rheumatic fever occurs when the strep bacteria is left to flourish and the body’s immune system begins to fight back. These antibodies begin to fight the body itself, damaging tissues and organs instead of the bacteria. Severe complications may result that affect the heart, joints, nervous system, and skin.

What are the symptoms of rheumatic fever?

There are several symptoms of rheumatic fever. Some may also be symptoms of other diseases. If you notice any of these in your child or yourself you should seek prompt medical attention due to the seriousness of rheumatic fever.

Symptoms include:

  • Fever
  • Muscle aches
  • Headache
  • Swollen and painful joints
  • A red rash with a jagged edge
  • Swollen, red tonsils
  • Chest pain
  • Fatigue
  • Uncontrollable movements in the hands, legs, feet, and face

Typically, symptoms of rheumatic fever begin 2 to 4 weeks after being infected by strep.

Last reviewed by a Cleveland Clinic medical professional on 09/15/2017.


  • Binotto M, Guilherme L, Tanaka A. Rheumatic Fever. Images in Paediatric Cardiology. 2002;4(2):12-31.
  • National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center. Rheumatic Fever Accessed 9/14/2017.
  • Sika-Paotonu D, Beaton A, Raghu A, et al. Acute Rheumatic Fever and Rheumatic Heart Disease. 2017 Mar 10 [Updated 2017 Apr 3]. In: Ferretti JJ, Stevens DL, Fischetti VA, editors. Streptococcus pyogenes : Basic Biology to Clinical Manifestations [Internet]. Oklahoma City (OK): University of Oklahoma Health Sciences Center; 2016-.
  • Centers for Disease Control. Group A Streptoccal (GAS) Disease Accessed 9/14/2017.

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