Rheumatic fever is an inflammatory disease that can affect the heart, joints, blood vessels, and nervous system following a streptococcal infection of the throat or skin. It is most common in children ages 5-15. Symptoms may include fever, joint pain and swelling, involuntary movements (chorea), and heart valve damage. Diagnosis is based on symptoms occurring after a streptococcal infection along with findings on physical exam and tests like echocardiogram and electrocardiogram. Treatment focuses on antibiotics to prevent recurrence as well as medications for symptoms like joint pain, heart failure, and chorea. Damage to heart valves may require long-term antibiotics or valve surgery.

1. Rheumatic fever

8. Aortic valve showing active valvulitis. The valve is slightly thickened and displays small vegetations – "verrucae"

9. Chest radiograph of an 8 year old patient with acute carditis before treatment

10. Same patient after 4 weeks

12. Subcutaneous nodule on the extensor surface of elbow of a patient with acute RF

13. Erythema marginatum on the trunk, showing erythematous lesions with pale centers and rounded or serpiginous margins

14. Closer view of erythema marginatum in the same patient