Malaysia
Search
Sign In
Rheumatic%20fever%20-%20acute Signs and Symptoms
Definition
Acute Rheumatic Fever (ARF)
- An autoimmune response to a previous group A beta-hemolytic streptococcal (GAS) infection causing acute generalized anti-inflammatory response primarily affecting the heart
- It also affects the joints, brain and skin
- Often presents in patients 5-15 years and uncommon before 3 years and after 21 years
- Patients presenting with ARF are severely unwell, in extreme pain and requires hospitalization
Signs and Symptoms
Initial episode usually occurs 2-4 weeks after GAS infection
Signs and symptoms found involving the skin usually develop with arthritis, carditis or Sydenham’s chorea
- History of an antecedent sore throat 1-5 weeks prior to onset is present in most patients
- Increased irritability and shortened attention span with personality changes [eg pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS)]
- Carditis in patient presenting with high fever and chest pains
- Heart failure (HF) with respiratory, peripheral or abdominal manifestations
- Dyspnea without rales and hacking, non-productive cough
- Nausea and vomiting and right upper quadrant or epigastric pain
- Murmurs
- Painful, tender, red, hot and swollen
- Migratory polyarthritis with fever
- Monoarthritis
- Arthralgia-like symptoms
- Tenosynovitis may also be seen
- Sydenham’s chorea
Signs and symptoms found involving the skin usually develop with arthritis, carditis or Sydenham’s chorea
- Subcutaneous nodules usually on the extensor surface of large joints
- Erythema marginatum
- Serpiginous, flat or slightly raised, non-scarring and painless rash
- Lethargy, malaise and fatigue in HF
- Pallor
- Epistaxis
- Fever
- Elevated white blood cells (WBC)
- Abdominal guarding, pain
- Anorexia
