Acute rheumatic fever

Acute rheumatic fever

Rheumatic fever is a post streptococcal autoimmune disorder. Many features of the disease were described by Sydenham as early as 17th century. Rheumatic fever is said to lick the joints and bite the heart because polyarthritis, the commonest manifestation in adults, leaves no sequelae while carditis often leaves back disabling sequelae.

Antibodies to antigens of group A beta hemolytic streptococci initiate autoimmune injury to human tissues. Aschoff bodies are the pathognomonic histologic features of rheumatic fever. They appear as early as 2 weeks from the onset of rheumatic fever.

Jones criteria were proposed for the diagnosis of rheumatic fever in 1944. Jones criteria has undergone various modifications and revisions since then. Major manifestations are carditis, polyarthritis, chorea, erythema marginatum and subcutaneous nodules. Supporting evidence for recent streptococcal infection is also needed.