Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis

Rheumatic fever is an inflammatory response to a previous streptococcal infection, which may have been mild or untreated. It affects the heart, nervous system, skin, and joints. It usually occurs in children younger than 18 years. Rheumatic fever is not contagious, but the strep infections that caused it is. The strep infection is curable with antibiotic treatment. Blood tests may be helpful in diagnosing the disease.

Living With Your Diagnosis
Signs and symptoms include fever, loss of appetite, mild rash, fatigue, paleness, small bumps under the skin over bony areas (such as the hands, wrists, elbows, and knuckles), and joint inflammation that is characterized by pain, swelling, and warmth. If the heart is involved, there may be shortness of breath, swelling of the ankles and around the eyes, and a rapid heartbeat. There may be uncontrolled jerky movements. The most common complication of this disease is damage to the heart valves, resulting in a heart murmur. In some cases the damaged valves may need surgical replacement.

Bed rest is required until the disease has subsided. This could take 2–5 weeks. Antibiotic treatment over a long period is needed. Let your doctor know if you are allergic to penicillin. In the early stages, a liquid or soft diet may be better tolerated, with progression to a normal diet high in calories, protein, and vitamins. Aspirin or other anti-inflammatory drugs are given for the muscle and joint pain. Common side effects of these drugs are ringing in the ears and stomach upset. After the initial infection is over, a daily dose of penicillin is necessary.

The DOs
• Take antibiotics as prescribed until finished.
• Take the daily dose of penicillin as instructed.
• Rest. Use a bedside commode so trips to the bathroom will be minimal.
• Encourage fluid intake while the fever is present.
• Resume activity gradually. It will be necessary to schedule rest periods and naps.
• Seek treatment for any sore throats in the future.
• Inform doctors or dentists of your history of the disease because you will need antibiotics before any surgical procedures.

The DON’Ts
• Don’t skip or stop antibiotics until finished.
• Don’t have any dental surgery or other surgeries until antibiotics are taken first.
• Don’t resume activity until fever and other symptoms subside.

When to Call Your Doctor
If during treatment you have:
• Swelling of the legs or ankles.
• Shortness of breath.
• Vomiting or diarrhea.
• A dry hacking cough.
• Severe abdominal pain.
• A temperature of 101°F or higher.