Rheumatic fever

Rheumatic fever is an inflammatory disease which may develop after an infection with streptococcus bacteria (such as strep throat or scarlet fever) and can involve the heart, joints, skin, and brain.

Signs

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, complete blood counts, and sedimentation rate. As part of the cardiac evaluation, an electrocardiogram may also be done.

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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.

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Major diagnostic criteria

These are also known as Jones criteria.

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

Minor diagnostic criteria

• Elevated erythrocyte sedimentation rate
• Elevated streptococcal antibody titer
• Prolonger PR interval on EKG
• Increased WBC count
• Elevated levels of C-reactive protein