First attack of rheumatic fever in an adult: the case for greater awareness.

A 40 year old white woman presenting with rash, fever, and migratory polyarthralgia developed a symmetrical polyarthropathy and remained unwell for 10 weeks. Fulfilment of the revised Jones criteria reinforced the clinical diagnosis of rheumatic fever. Antistreptococcal antibodies peaked four to six weeks into the illness and declined thereafter.