Rheumatic Fever: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate rheumatic fever:

  • Fever
  • Headache
  • Sweating

The manifestations of rheumatic fever usually occur circa one to three weeks after an upper respiratory tract infection (pharyngitis (pharyngitis), tonsillitis (tonsillitis) or similar). The following manifestations of rheumatic fever are possible:

Skin and subcutaneous (L00-L99).

  • Erythema anulare rheumaticum marginatum (in circa 10%) – truncal circular (segmental), bluish to pale red skin redness.
  • Erythema nodosum (synonyms: nodular erythema, dermatitis contusiformis, erythema contusiforme; plural: erythemata nodosa) – granulomatous inflammation of the subcutis (subcutaneous fat tissue), also known as panniculitis, and painful nodulation (red to blue-red color; later brownish). The overlying skin is reddened. Localization: both lower leg extensor sides, on the knee and ankle joints; less frequently on the arms or buttocks.
  • Rheumatoid nodules (in circa 30%) – rheumatoid subcutaneous nodules.

Cardiovascular system (I00-I99)

  • Endocarditis (endocardial inflammation).
  • Myocarditis (inflammation of the heart muscle)
  • Pancreatitis (inflammation of all layers of the heart).
  • Pericarditis (inflammation of the pericardium)

Musculoskeletal system and connective tissue (M00-M99)

  • Polyarthritis, reactive – inflammation of several joints, especially large joints (knee joint, ankle joint); can jump from joint to joint (so-called jumping polyarthritis) and causes severe pain; in the course of the disease, there may also be involvement of the finger and toe joints

Psyche – nervous system (F00-F99; G00-G99)

  • Encephalitis (inflammation of the brain), which typically leads to the picture of chorea minor (see below).
  • Chorea minor – involvement of the corpus striatum; almost exclusively in children; leads to hyperkinesia (lightning-like movements), muscle hypotonia, and mental changes

Notice. Children and adolescents are more likely to develop carditis (inflammation of the heart) and adults are more likely to develop arthritis.