Rheumatic fever is an inflammatory autoimmune disease that may develop after an infection with group A Streptococcus bacteria (such as strep throat or scarlet fever). The disease can affect the heart, joints, skin, and brain. Rheumatic fever is common worldwide and is responsible for many cases of damaged heart valves. It is not common in the United States, and usually occurs in isolated outbreaks. The latest outbreak was in the 1980s. Rheumatic fever mainly affects children ages 5 -15, and occurs approximately 14-28 days after strep throat or scarlet fever. Symptoms include: abdominal pain, fever, heart (cardiac) problems, which may not have symptoms, or may result in shortness of breath and chest pain, joint pain, arthritis (mainly in the knees, elbows, ankles, and wrists), joint swelling; redness or warmth, nosebleeds (epistaxis), skin nodules, skin rash, skin eruption on the trunk and upper part of the arms or legs, eruptions that look ring-shaped or snake-like, and sydenham chorea (emotional instability, muscle weakness and quick, uncoordinated jerky movements that mainly affect the face, feet, and hands). If you are diagnosed with acute rheumatic fever you will be treated with antibiotics. Anti-inflammatory medications such as aspirin or corticosteroids reduce inflammation to help manage acute rheumatic fever. If rheumatic fever returns, your doctor may recommend you take low-dose antibiotics continually, especially during the first 3 -5 years after the first episode of the disease. Heart complications may be severe, particularly if the heart valves are involved.