Bisno, A. L. Veterans Administration Medical Center, Miami, Florida.
Dale, James B. Veterans Affairs Medical Center, Memphis, Tennessee.
Last reviewed:August 2020
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An illness that follows an upper respiratory infection with group A streptococci and is characterized by inflammation of the joints (arthritis) and the heart (carditis). Rheumatic fever is an inflammatory disease, particularly affecting the heart, joints, and blood vessels. It develops primarily as a complication of infection (for example, strep throat infection) caused by group A streptococcal bacteria; the most prominent member of this bacterial group is Streptococcus pyogenes (see illustration). In patients suffering from rheumatic fever, arthritis typically involves multiple joints and may migrate from one joint to another. Carditis may involve the outer lining of the heart (pericarditis), the heart muscle itself (myocarditis), or the inner lining of the heart (endocarditis). Some affected individuals also develop a rash (erythema marginatum), nodules under the skin, or Sydenham's chorea (a neurologic disorder characterized by involuntary, uncoordinated movements of the legs, arms, and face). These clinical manifestations may occur singly or in combination. Although most disappear completely, damage to heart valves may be permanent and progressive, leading to severe disability or death from rheumatic heart disease years after the initial attack. See also: Arthritis; Blood vessel; Heart (vertebrate); Heart disorders; Infection; Inflammation; Joint (anatomy); Medical bacteriology; Streptococcus
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