Rheumatic Fever

Rheumatic Fever, once common acute inflammatory disease, characterized by fever and pain, tenderness, redness, and swelling of the joints. Rheumatic fever can cause inflammation of the heart and damage to the heart valves (Endocarditis). First attacks usually occur from the age of 7 to 12 or 14; recurrent attacks can occur throughout adult life. The mortality from the acute attack is low, and most cases subside spontaneously. Often, however, inflammation of the heart leads to scarring and deformity, causing the valves to malfunction. This strain on the heart muscle causes rheumatic heart disease, which can cause death in middle or later life.

Acute rheumatic fever is a complication of streptococcal infection, such as strep throat, scarlet fever, or erysipelas. It sometimes develops after infections so mild as to pass unnoticed. Rheumatic fever begins either insidiously or abruptly after a latent period of two to six weeks following the streptococcal infection. Aside from fever, malaise, and migratory arthritis, patients may develop nodules under the skin, skin rashes, abdominal pain, pleurisy, and chorea. The most serious aspect of the disease, however, is the involvement of the heart (carditis).

Treatment involves the use of penicillin to eradicate streptococci that may still be present, bed rest, and administration of salicylates or corticosteroids. It may take many weeks or months before the attack runs its course. Rheumatic fever has become relatively rare, probably due at least in part to the widespread use of antibiotics.