INFORMATION FOR WOMEN WHO HAVE RHEUMATIC FEVER, OR COMPLICATIONS OF RHEUMATIC FEVER, DURING PREGNANCY OR BREASTFEEDING

What is rheumatic fever?

Rheumatic fever is an inflammatory condition that can occur as a complication of infection with a category of bacteria called group A ß-hemolytic Streptococcus (GAS) – usually streptococcal pharyngitis (strep throat), but it also can result from certain other GAS conditions, such as scarlet fever. The majority of such GAS infections are of the species Streptococcus pyogenes - rheumatic fever develops when the infection is not treated appropriately with antibiotics. As the immune system fights off the bacteria, immune cells and antibodies that they produce attack certain body tissues that have been damaged by the GAS, particularly in the heart, nervous system, skin, and joints. It takes 2 to 4 weeks after the strep infection before the immune attack makes the person sick. Still, then varying symptoms develop, including arthritis, fever, a particular kind of rash, inflammation of all layers of the heart (pancarditis), and a kind of fast, jerking, uncoordinated movement of the hands, feet, and face. Known as Sydenham chorea (also “chorea minor” and “St. Vitus dance”, the movement is due to the immune system damaging what is called the basal ganglia within the brain, specifically cells of a basal ganglia structure called the corpus striatum. In this early form, the condition is known as acute rheumatic fever (ARF), which typically strikes children ages 5-15, rather than women of child-bearing age. However, rheumatic fever is most notorious for long-term effects that can develop in the heart, known as rheumatic heart disease (RHD).