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Medical Health Encyclopedia
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Rheumatic fever

Alternative Names:
Acute rheumatic fever

Symptoms:
  • Fever
  • Joint pain, migratory arthritis -- involving primarily knees, elbows, ankles, and wrists
  • Joint swelling; redness or warmth
  • Abdominal pain
  • Skin rash (erythema marginatum)
    • Skin eruption on the trunk and upper part of arms or legs
    • Eruptions that are ring-shaped or snake-like in appearance
  • Skin nodules
  • Sydenham's chorea -- emotional instability, muscular weakness and rapid, uncoordinated jerky movements affecting primarily the face, feet and hands
  • Epistaxis (nosebleeds)
  • Cardiac (heart) involvement which may be asymptomatic or may result in shortness of breath, chest pain


Signs and tests:

Given the different manifestations of this disease, there is no specific test which can definitively establish a diagnosis. In addition to a careful physical examination of heart sounds, skin, and joints, blood samples may be taken as part of the evaluation. These include tests for recurrent strep infection (ASO or antiDNAse B), complete blood counts, and sedimentation rate (ESR). As part of the cardiac evaluation, an electrocardiogram may also be done.

Text Continues Below



In order to standardize the diagnosis of rheumatic fever, several minor and major criteria have been developed. These criteria, in conjunction with evidence of recent streptococcal infection, establish a diagnosis of rheumatic fever.

The major diagnostic criteria include:

  • Carditis (heart inflammation)
  • Polyarthritis
  • Subcutaneous skin nodules
  • Chorea (Sydenham's chorea)
  • Erythema marginatum.

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