Acute autoimmune reaction/illness following beta-haemolytic streptococcus infection – usually 2-4 weeks post infection. more common in ages 5 to 15 years.
Major manifestations: - ACCES – Arthritic, Carditis, Chorea, Erythema, Subcutaneous nodules
Minor manifestations: - fever, arthralgia, previous rheumatic heart disease, elevated ESR, acute phase reaction, elevated c-reactive protein, leucocytosis.
• 75% develop joint symptoms – usually large joints
• after repeated attacks of arthritis develop a deforming non-erosive arthropathy (Jaccoud’s).
• on x-ray flexion and lateral deviation of digits; periarticular osteoporosis; joint space narrowing
Salicylates (dramatic response can help confirm diagnosis); antibiotics
Long term sequelae:
• damage to heart valves ( risk for thrombus)
• cardiac failure
• bacterial endocarditis