A sequel of Group A Beta hemolytic streptococcal ,upper respiratory tract infection, age 5-15 yrs, and young adults, 3% of these get Acute Rheumatic Fever. The pathogenic mechanism is unknown. But the most widely held view is that it is due to autoimmune, immunologic response to either extracellular or somatic antigen of group A beta hemolytic streptococcus. It runs in families.

Criteria for diagnosis:

1) Prior Infection with Group A, beta hemolytic streptococcus
2) pancarditis including MR (mitral regurgitation) and AI (aortic insufficiency)
3) migratory arthritis (inflammation of various joints)
4) erythema marginatum rash
5) subcutaneous nodules
6) Chorea (involuntary movements of extremities)
7) increased anti streptolysin O titer (blood test of an antibody against the streptococcus group A beta hemolytic type.

Treatment of beta hemolytic group A infection consists of penicillin and long term penicillin prophylaxis