A detailed and thorough history from the patient is necessary. Specific areas of focus when obtaining a history from the patient include prior rheumatic fever infection, family history of rheumatic fever, and recent streptococcal infection. Common symptoms of rheumatic fever include fever, nose bleeds, and skin rash.

A detailed and thorough history from the patient is necessary. Specific areas of focus when obtaining a history from the patient include:

• Prior rheumatic fever infection
• Family history of rheumatic fever
• Recent streptococcal infection
• Antibiotic regimen
• Recent travel, especially to developing countries

Rheumatic fever is a non-suppurative sequelae that occurs 2-4 weeks following streptococcal pharyngitis or skin infection. Common symptoms of rheumatic fever include:^[1][2][3]

• Fever
• Nose bleeds
• Skin rash (see erythema marginatum)
• Chest pain
• Abdominal pain
• Swollen, painful, tender joints
• Palpitations
• Jumpy body movements that cannot be controlled observed on the face, feet and hands; emotional disturbances with outbursts of unusual behavior such as inappropriate laughing or crying (see Sydenham’s chorea, also known as St. Vitus’ dance)
• Sore throat
• Malaise
• Fatigue
• Shortness of breath
• Bumps or nodules that appear under the skin
• Difficulty swallowing
• Seizure
• Coma