Rheumatic fever is usually treated in hospital, so that your heart can be carefully monitored.

Treatment goals

There is no cure for rheumatic fever so treatment focuses on three goals:

• to eradicate any streptococcal bacteria that may be remaining in your body with antibiotics,
• to help relieve symptoms with anti-inflammatory medication, and
• to prevent long-term damage to your heart.

Antibiotics

The reason it is important to get rid of any streptococcal bacteria left in your body is that if you then experience another throat infection you may also experience another episode of rheumatic fever. Repeated episodes of rheumatic fever carry an increased risk of causing permanent damage to the heart.

It is usually recommended that you are given injections of antibiotics (intravenous antibiotics) every two to three weeks over the course of many years. In cases of children, it is usually recommended that they are treated with antibiotics until they reach adulthood.

Anti-inflammatory medications

Anti-inflammatory medications can be used to relieve symptoms of joint pain and swelling (arthritis), and in severe cases, reduce inflammation of the heart.

Common type of anti-inflammatory medications used to relieve arthritis include the non-steroidal anti-inflammatory drugs (NSAIDs) type of painkillers such as ibuprofen, and aspirin.

The use of aspirin is not usually recommended in children under the age of 16 as it carries a very small risk of causing Reye's syndrome, a potentially fatal condition that can cause liver and brain damage.

However, an exception is usually made in cases of rheumatic fever as most children are only required to take a low-dose aspirin for one to two weeks and it has proved extremely successful in relieving symptoms. So most health professionals feel that the benefits of aspirin in the treatment of rheumatic fever far outweigh the risks.

If the results of your electrocardiogram (ECG) show that you have moderate to severe inflammation of the heart, you will probably be treated with a type of steroid medication called prednisolone.     

Prednisolone isusually given in tablet form for a course of two to six weeks.

Side effects of prednisolone include:

• headache,
• dizziness,
• problems sleeping, and
• weight gain.

These side effects should pass once you finish your course.

Other treatments

If you are experiencing symptoms of chorea (uncontrollable physical jerking), you may be given a type of medication known as a neuroleptic. Neuroleptics work by blocking the nerve signals that are responsible for chorea.

A widely used neuroleptic in the treatment of chorea is called haloperidol, which is usually given in injection form until the symptoms are under control.

Common side effects of haloperidol include:

• agitation,
• problems sleeping,
• headache,
• dizziness,
• changes in mood, such as feeling very low or depressed, and
• problems with physical movement, such as trembling, having a shuffling unbalanced walk and unusually slow movements.

These side effects should pass once you stop taking haloperidol.