Acute rheumatic fever.

Acute rheumatic fever is an inflammatory response to group A streptococcal infectionwhich typically occurs two to three weeks after a throat infection.Worldwide, approximately 500 000 new cases of acute rheumatic fever occur annually, and at least 15 million people have chronic rheumatic heart disease. 2 Acute rheumatic fever is characterised by a clinical syndrome, and the most common manifestations are painful joints and carditis. Carditis occurs in about 80% of people with rheumatic fever and commonly affects the mitral and aortic valves, resulting in regurgitation. Other less common clinical features include abnormal involuntary movements (chorea), rash (erythema marginatum), and subcutaneous nodules. The inflammatory process slowly resolves over weeks to months, but about half of individuals are left with chronic rheumatic heart disease.Although death from acute rheumatic carditis is not common, chronic rheumatic heart disease causes considerable morbidity including arrhythmias, stroke, infective endocarditis, pregnancy complications, and premature death. 9 The aim of this review is to discuss acute rheumatic fever, in particular its diagnosis and management for the non-specialist. What causes acute rheumatic fever?