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Related Subjects: |Congenital Acyanotic Heart Disease |Congenital Cyanotic Heart Disease |Cardiac Embryology |Cyanosis - Central and Peripheral |Down's syndrome (Trisomy 21) |Tetralogy of Fallot |Patent Foramen Ovale (PFO) |Ventricular Septal defect (VSD) |Mitral Regurgitation (Incompetence) |Mitral Stenosis |Mitral Stenosis vs Regurgitation |Mitral Valve prolapse |Atrial Fibrillation (AF) |Cardiac Valve replacement |Prosthetic Valves<
Acute Rheumatic fever |
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To diagnose rheumatic fever, the revised Jones criteria require the presence of either two major criteria or one major and two minor criteria, along with evidence of a preceding Group A streptococcal infection.
Category | Criteria | Description |
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Major Criteria | Carditis | Evidence of inflammation of the heart, which can manifest as endocarditis, myocarditis, or pericarditis. Clinical signs include new or changing heart murmurs, cardiomegaly, heart failure, or pericardial rubs. |
Polyarthritis | Inflammation of multiple large joints, typically migratory, involving knees, ankles, elbows, and wrists. The joints are swollen, tender, and red, and the condition responds well to anti-inflammatory treatment. | |
Chorea (Sydenham's chorea) | Involuntary, rapid, irregular movements of the face, hands, and feet, often associated with emotional lability. This neurological manifestation is a late sign and may occur months after the acute infection. | |
Erythema Marginatum | A distinctive rash with pink rings on the trunk and inner surfaces of the limbs, which may come and go and does not itch. It is typically non-pruritic and not painful. | |
Subcutaneous Nodules | Painless, firm collections of collagen fibers over bones or tendons, usually occurring on extensor surfaces such as the elbows, knees, and wrists. | |
Minor Criteria | Arthralgia | Joint pain without actual swelling. It is considered a minor criterion if polyarthritis is not present as a major criterion. |
Fever | Fever typically ranging from 38.2°C to 39.4°C (100.8°F to 102.9°F) is a minor criterion, particularly when associated with other signs of systemic inflammation. | |
Elevated Acute Phase Reactants | Indicators of inflammation such as elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP). Leukocytosis may also be present. | |
Prolonged PR Interval | An electrocardiogram (ECG) finding indicating a delay in conduction between the atria and ventricles, reflecting carditis. | |
Supporting Evidence | Recent Group A Streptococcal Infection | Evidence of a preceding streptococcal infection, such as a positive throat culture, rapid streptococcal antigen test, or elevated or rising streptococcal antibody titer (ASO or anti-DNase B). |