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Tests and diagnosis
By Mayo Clinic staffYour doctor makes a diagnosis of rheumatic fever based on:
- Signs and symptoms you report
- Evidence of inflammation
- Evidence of past group A streptococcal infection
Physical exam
Your child's doctor will conduct a thorough physical examination that may include:
- Checking the joints for signs of inflammation
- Examining the skin for nodules under the skin or a rash
- Listening to the heart for abnormal rhythms, murmurs or muffled sounds that may indicate inflammation of the heart
- Conducting a series of simple movement tests to detect indirect evidence of inflammation of the central nervous system
Tests for strep infection
If your child was already diagnosed with a strep infection, your doctor may not order any additional tests for the bacterium. If your doctor orders a test, it will most likely be a blood test that can detect antibodies to strep bacteria circulating in the blood. The actual bacteria may no longer be detected in your child's throat tissues or blood.
Electrocardiogram (ECG)
An electrocardiogram — also called an ECG or EKG — records electrical signals as they travel through your child's heart. Your doctor can look for patterns among these signals that indicate inflammation of the heart or poor heart function.
Echocardiography
An echocardiogram uses sound waves to produce live-action images of the heart. This common test may enable your doctor to detect inflammation. Damage to heart valves isn't likely to occur early in the disease, but an echocardiogram is capable of revealing such problems.
- Rheumatic fever. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec19/ch281/ch281a.html. Accessed Dec. 3, 2008.
- Carapetis JR, et al. Acute rheumatic fever. Lancet. 2005;366:155-168.
- Gibofsky A, et al. Epidemiology and pathogenesis of acute rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Dec. 4, 2008.
- Gibofsky A, et al. Clinical manifestations and diagnosis of acute rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Dec. 4, 2008.
- Hahn RG, et al. Evaluation of poststreptococcal illness. American Family Physician. 2005;71:1949-1954.
- Strep throat: Symptoms. National Institute of Allergy and Infectious Diseases. http://www3.niaid.nih.gov/topics/strepThroat/symptoms.htm. Accessed Dec. 15, 2008.
- Parenting corner Q&A: Sore throat. American Academy of Pediatrics. http://www.aap.org/publiced/BK0_SoreThroat.htm. Accessed Dec. 15, 2008.
- When your infant or child has a fever. American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/children/parents/common/common/069.html. Accessed Dec. 15, 2008.
- Gerber M. Streptococcus pyogenes (Group A streptococcus). In: Long S, et al., eds. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa.: Churchill Livingstone/Elsevier; 2008. http://www.mdconsult.com/das/book/body/113823919-10/783584111/1679/122.html#4-u1.0-B978-0-443-06687-0..50121-1--cesec21_2521. Accessed Dec. 15, 2008.
- Weinberg G. Rheumatic fever. The Merck Manuals Online Medical Library: Home Edition for Patients and Caregivers. http://www.merck.com/mmhe/sec23/ch272/ch272h.html. Accessed Dec. 3, 2008.
- Gibofsky A, et al. Treatment and prevention of acute rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Dec. 4, 2008.
