Rheumatic Fever

Causes

The exact cause of rheumatic fever is not clear. Medical research has focused on an abnormal response by the immune system to specific types of streptococcal bacteria. Researchers are also studying whether some people have a greater genetic disposition to have an abnormal immune system response to streptococcal antigens.

Proper and prompt treatment of strep throat and scarlet fever with antibiotics usually prevents the development of rheumatic fever. Children with these infections should take their full course of antibiotics, even after symptoms are gone.

Prevention of further episodes of rheumatic fever is very important for a child who has had one episode. Experts recommend monthly intramuscular injections of penicillin to prevent recurrence, through high school or lifelong, especially if the young adult enters the military or becomes a school teacher where exposure to strep is higher. Some patients may elect to take a daily dose of antibiotics by mouth, but this may not be as effective as the monthly shots. For patients without documented carditis during the initial attack, antibiotic prophylaxis can be discontinued in early adulthood if the patient is at least five years from the most recent attack of rheumatic fever.