Rheumatic Fever

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

A free rheumatic fever e-learning course from the Ministry of Health is available at Learnonline.health.nz 

This user guide provides information on how to access the course.

The course is free and is aimed at primary care nurses, public health nurses and community health workers working with families whose children are at risk of developing rheumatic fever.  The course is also useful for locum general practitioners, general practitioners new to New Zealand and pharmacists.

Participants will receive a certificate showing they’ve successfully completed the two hour course.

Made up of four modules, the course includes information about:

• rheumatic fever in New Zealand
• how to identify people at high risk of rheumatic fever and how to assess and manage sore throats based on the identified risk
• ways to reduce the transmission of sore throats within the household
• how to identify the main symptoms and signs of rheumatic fever, as well as how it is typically managed

The course was developed in consultation with rheumatic fever experts, primary care nurses and community health workers.

Read more about the school based throat swabbing programmes

Ministry of Health resources

Click here to view Ministry of Health learning resources

Heart Foundation resources

Rheumatic fever resources are available to order from the resource page of the Heart Foundation website 

5 messages to keep your family healthy

The 5 messages to keep your family healthy resources are aimed at reducing hospitalisations for preventable diseases such as rheumatic fever and skin infections.