rheumatic fever

a severe disease, affecting children and young adults, which is complication of upper RESPIRATORY TRACT infection with BACTERIA known as Haemolytic streptococci. The symptoms include fever, JOINT pain and ARTHRITIS that progresses from joint to joint, a characteristic red rash, known as ERYTHEMA marginatum, and also painless nodules that develop beneath the skin over bony protuberances such as the elbow, knee and back of the wrist. In addition there is CHOREA and INFLAMMATION of the HEART , including the muscle, valves and membranes. The condition may lead to rheumatic heart disease in which there is scarring and inflammation of heart structures. The initial treatment consists of destroying the streptococci that cause the disease with ANTIBIOTIC drugs such as PENICILLIN . Other drugs are also used, such as non-steroidal anti-inflammatory drugs (see NSAID ) and CORTICOSTEROIDS . Surgery may be required later in life to replaced damaged heart valves.