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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 recent 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 altered structures within the heart. Damage to heart valves isn't likely to occur early in the disease, but an echocardiogram can show such problems.
- Fort GG. Rheumatic fever. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05610-6..00027-5--sc0105&isbn=978-0-323-05610-6&type=bookPage§ionEid=4-u1.0-B978-0-323-05610-6..00027-5--sc0105&uniqId=224600605-3. Accessed Oct. 28, 2010.
- Rheumatic fever. In: Marx JA, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/books/page.do?sid=1075999583&eid=4-u1.0-B978-0-323-05472-0..00081-5--s0050&isbn=978-0-323-05472-0&type=bookPage§ionEid=4-u1.0-B978-0-323-05472-0..00081-5--s0050&uniqId=224600605-4. Accessed Oct. 28, 2010.
- Rheumatic fever. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec19/ch281/ch281a.html. Accessed Oct. 28, 2010.
- Choby B. Diagnosis and treatment of streptococcal pharyngitis. American Family Physician. 2009;79:383.
- Gibofsky A, et al. Epidemiology and pathogenesis of acute rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Oct. 28, 2010.
- Gibofsky A, et al. Treatment and prevention of rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Oct. 28, 2010.
- Report for the second meeting of World Health Organization's subcommittee of the Expert Committee of the Selection and Use of Essential Medicines: Antibiotic use for the prevention and treatment of rheumatic fever and rheumatic heart disease in children. Geneva, Switzerland: Royal Hobart Hospital and University of Tasmania. http://www.who.int/selection_medicines/committees/subcommittee/2/RheumaticFever_review.pdf. Accessed Oct. 28, 2010. Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 3, 2010.
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