Rheumatic fever begins one to six weeks after an untreated streptococcal infection. The joints, especially the wrists, elbows, knees, and ankles become red, sore, and swollen. The infected person develops a high fever, and possibly a rapid heartbeat when lying down, paleness, shortness of breath , and fluid retention. A red rash over the trunk may come and go for weeks or months. An acute attack of rheumatic fever lasts about three months.
Rheumatic fever can cause permanent damage to the heart and heart valves.
It can be prevented by promptly treating streptococcal infections with antibiotics . It does not occur if all the streptococcus bacteria are killed within the first 10-12 days after infection. Although these diseases are caused by group A Streptococci, they rarely begin with strep throat. Usually the streptococcus bacteria enters the body through a skin wound. These complications are rare.