Sunday, February, 12, 2012

Rheumatic fever

Table of Contents

Alternative Names

Acute rheumatic fever


Symptoms
  • Abdominal pain
  • Fever
  • Heart (cardiac) problems, which may not have symptoms, or may result in shortness of breath and chest pain
  • Joint pain, arthritis (mainly in the knees, elbows, ankles, and wrists)
  • Joint swelling; redness or warmth
  • Nosebleeds (epistaxis)
  • Skin nodules
  • Skin rash (erythema marginatum)
    • Skin eruption on the trunk and upper part of the arms or legs
    • Eruptions that look ring-shaped or snake-like
  • Sydenham chorea (emotional instability, muscle weakness and quick, uncoordinated jerky movements that mainly affect the face, feet, and hands)

Signs and tests

Because this disease has different forms, no one test can firmly diagnose it. Your doctor will perform a careful exam, which includes checking your heart sounds, skin, and joints.

Tests may include:

  • Blood test for recurrent strep infection (such as an ASO test)
  • Complete blood count
  • Electrocardiogram
  • Sedimentation rate (ESR)

Several major and minor criteria have been developed to help standardize rheumatic fever diagnosis. Meeting these criteria, as well as having evidence of a recent streptococcal infection, can help confirm that you have rheumatic fever.

The major criteria for diagnosis include:

  • Arthritis in several joints (polyarthritis)
  • Heart inflammation (carditis)
  • Nodules under the skin (subcutaneous skin nodules)
  • Rapid, jerky movements (chorea, Sydenham chorea)
  • Skin rash (erythema marginatum)

The minor criteria include:

  • Fever
  • High ESR
  • Joint pain
  • Other laboratory findings

You'll likely be diagnosed with rheumatic fever if you meet two major criteria, or one major and two minor criteria, and have signs that you've had a previous strep infection.


Review Date: 05/09/2010
Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pahtophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)