Rheumatic fever

Alternative names:

adult rhumatic fever; juvenile rheumatic fever

Symptoms:

• fever
• joint pain, "arthritis type" (location moves from joint to joint, migratory polyarthritis)
• joint swelling
• epistaxis (nosebleeds)
• abdominal pain
• vomiting
• skin rash (erythema marginatum)
  • enlarging red patch on the body
  • may be ring-shaped or snake-like in appearance

• skin nodules
• unusual, jerky movements (Sydenham's chorea)

Other symptoms include:

• muscle pain
• confusion
• decreased muscle tone, weakness
• shakiness of one or more parts of the body (Sydenham's chorea)
• poor speech (Sydenham's chorea)
• cough
• excessive tiredness, fatigue

Signs and tests:

An examination shows joint swelling, lumps, or skin changes over the joints or bony prominences.

• An ECG will demonstrate myocarditis (heart inflammation).
• An echocardiogram will show myocarditis.
• A chest X-ray may also be recommended.
• A CBC shows increased white blood cell count.
• The sedimentation rate (ESR, ZSR) is elevated.
• ASO and anti-DNAase B levels may be elevated.

This disease may also alter the results of the following tests:

• quantitative immunoglobulins (nephelometry)
• immunoelectrophoresis - serum
• complement component 3
• complement
• blood differential