[Adult-onset acute rheumatic fever: 4 cases in Guadeloupe].

OBJECTIVE Rheumatic fever has become infrequent in developed countries. Recent regional epidemics, particularly in North America, brought our attention to this disease in our area. In the French Caribbean Islands, rheumatic fever remains an important health problem despite much progress in the last 15 years. METHODS A retrospective survey over the last 5 years identified 19 cases of rheumatic fever in Guadeloupe in subjects over 19 years of age. RESULTS Among these subjects 4 cases of rheumatic fever beginning in adulthood were analysed and compared with data in the literature. CONCLUSION The diagnosis of rheumatic fever beginning in adulthood is difficult to establish. Joint symptoms are variable and cardiac involvement, which occurs in 30 to 40% of the cases, is highly suggestive. The kinetics of antistreptococci antibodies confirms the diagnosis.