Rheumatic fever
Key facts
- Rheumatic fever is an illness that can happen after an infection with group A streptococcus (strep A).
- Rheumatic fever can affect many body systems, including your heart, joints, and skin.
- Aboriginal and/or Torres Strait Islander children living in rural or remote areas are most at risk.
- Preventing and treating strep A infection can help prevent rheumatic fever.
What is rheumatic fever?
Rheumatic fever is also known as acute rheumatic fever (ARF). It is an autoimmune condition that can follow an infection caused by group A Streptococcus. These bacteria are also called Streptococcus pyogenes, GAS or Strep A.
Strep A bacteria can cause infection in your throat. This is known as pharyngitis or strep throat. It can also cause other infections such as impetigo, cellulitis and scarlet fever.
Rheumatic fever can affect parts of your body such as the:
- heart
- joints
- brain
- skin
What are the symptoms of rheumatic fever?
Rheumatic fever symptoms can appear from days to months after a Strep A infection.
Symptoms of rheumatic fever can vary between people. They can range from very mild to severe and may include:
Less common signs include:
- jerky movements of your hands, legs, tongue and face
- lumps on your elbows, wrists, knees, ankles and spine
- a rash on your skin, such as your chest, arms and legs
What causes rheumatic fever?
Rheumatic fever is caused by your body's immune response to the Strep A infection.
Sometimes, your immune system can get confused by an infection and mistakenly attack your body. This is called an autoimmune reaction. This reaction to Step A infection causes inflammation, which causes the symptoms of rheumatic fever.
You may be at an increased risk of rheumatic fever if you are:
- an Australian Aboriginal and/or Torres Strait Islander person
- a New Zealand Māori or Pacific Islander
- a child aged 5 to 14 years
- female
You are also more likely to get rheumatic fever if you:
- have had it before
- live in a rural or remote location
- live in crowded housing
Strep A can spread through respiratory droplets (when someone coughs or sneezes), or in contaminated food.
When should l see my doctor?
See your doctor if you are sick and have:
- a sore throat
- a skin infection
- fever and sore joints
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How is rheumatic fever diagnosed?
Your doctor will talk with you about your symptoms and will examine you. They may arrange tests, like:
- blood tests
- a throat swab
- an echocardiogram
These tests can help your doctor find out if you are likely to have rheumatic fever.
There is no single test used to diagnose rheumatic fever.
If you are at higher risk of having rheumatic fever and you have symptoms of rheumatic fever, see your doctor.
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How is rheumatic fever treated?
If your doctor thinks you have rheumatic fever, you will usually be treated in hospital. In hospital, a team of healthcare professionals can look after you.
Your treatment will include:
- monitoring, such as with blood tests and imaging
- antibiotics for the Strep A infection
- rest
Medicine can also help with the symptoms. You may be given medicines such as paracetamol for pain relief and to reduce your fever. Your doctor may also recommend medicines to reduce inflammation in your joints. You may also be given medicine to reduce any jerky movements you're having.
Long-term treatment may include antibiotics. This can help prevent future Strep A infection and prevent complications.
What are the complications of rheumatic fever?
The main complication of rheumatic fever is rheumatic heart disease (RHD).
RHD is when your heart valves are damaged due to the inflammation caused by rheumatic fever. It can cause complications such as:
If you or someone else has signs of a stroke, call triple zero (000) and ask for an ambulance immediately.
If you have RHD, you will need medical care and follow up throughout your life. Treatment with antibiotics can help prevent your condition from getting worse. Treatment can help prevent you from needing heart surgery.
How can rheumatic fever be prevented?
Good hygiene practices can help prevent Strep A infection. This can include:
- covering your mouth when you cough or sneeze, such as by using a tissue
- not sharing eating utensils or towels with others
- washing your hands well before preparing food
You can help prevent rheumatic fever by seeing the doctor or nurse when you're sick.
If you have a Strep A infection, it's important to avoid spreading it to others. Stay away from other people as much as you can.
Resources and support
The Heart Foundation website has information on acute rheumatic fever and rheumatic heart disease.
Languages other than English
The Sydney Children's Hospital Network has a fact sheet on Strep A bacteria in Arabic, Hindi, Vietnamese, Chinese and Korean.
Information for Aboriginal and/or Torres Strait Islander peoples
Australian Indigenous HealthInfoNet has information about ARF and rheumatic heart disease.
The END RHD website has information on rheumatic heart disease for Aboriginal and/or Torres Strait Islander peoples.
You can read about the Northern Territory Rheumatic Heart Disease Program. This includes resources for patients and families.
You can call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.
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Last reviewed: February 2026
