Concerned about Rheumatic fever after Strep

My 6 year old daughter came down with a fever and sore throat about 12-13 days ago. I knew strep throat was going around so I took her to the dr. She refused to let them do the culture so they said, "If she gets worse, it's strep, and we'll treat her.  If she gets better, it's not." Well, she did get better, the fever went away and she seemed to have just a stuffy nose. Well, I ended up getting strep throat a couple days ago  (positive culture-very painful as an adult, by the way!!)so I thought she must have had it and I got it from her. Now she woke up this morning with red spots on her face, took her to the dr. and it's impitego, a form of strep. We started the Pennicillin (penicillin) tonight, but I am concerned we may have waited too long. She has acted fine, no fever or anything. How long after the first signs of strep do you run the risk of Rheumatic fever?? She has Mitral Valve Prolapse like me, too. I am very worried about this.
Thanks,
Mary Lou

[Kevin Pho, MD]

Rheumatic fever can occur 2-4 weeks after the initial event of strep throat.  

The test to consider would be blood tests, such as the the antibody antistreptolysin O.  Other antistreptococcal antibodies can be considered, such as anti-DNAse B, anti-DNAse, and antihyaluronidase, if the initial tests are negative.

Accompanying symptoms such as arthritis or involuntary movements can be associated with rheumatic fever.  

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b