Rare Symptoms
Erythema marginatum
- Highly specific to ARF
- Cutaneous lesion: reddish pink borderpale centreround or irregular shape
- Often on trunk, abdomen, inner arms or thighs
- Highly suggestive of carditis
Subcutaneous nodules
- Usually 0.5-2cm in diameter: Firm, non-tender, isolated or in clusters
- Most common along on the extensor surfaces of the joint: knees, elbows, wrist
- Also on bony prominences, tendons, dorsi of feet, occiput or cervical spine.
- Last a few days only
- Often associated with carditis
Sydenham’s Chorea
- Extrapyramidal disorder:
- Fast, clonic involuntary movements (especially face and limbs)
- Muscular hypotonus
- Emotional lability
- First sign: difficulty walking, talking, writing
- Usually a late manifestation, can be months after infection
- May be the only manifestation of ARF
- Often associated with carditis
- Usually benign and resolves in 2-3 months
- But can last for more than 2 years
