Acute rheumatic fever (ARF) is an autoimmune, inflammatory response to pharyngeal infection with group A Streptococcus (GAS) that affects multiple organ systems.
Can lead to rheumatic...
Mainly a clinical diagnosis
Laboratory evidence of preceding GAS infection is needed whenever possible (see “Initial Tests (lab, imaging)”)
Revised 2015 Jones criteria (4)[C]
Initial ARF: 2 maj...
Antibiotic
Anti-inflammatory agent (aspirin or naproxen)
Manage other manifestations as needed (e.g., chorea, dysrhythmia, pericarditis, myocarditis, valvular disease, or heart...
Secondary prophylaxis: ARF patients should be on a prophylactic antibiotic from time of diagnosis until at least age 21 years, and possibly indefinitely depending...
I00 Rheumatic fever without heart involvement
I01.9 Acute rheumatic heart disease, unspecified
I01.0 Acute rheumatic pericarditis
I01.1 Acute rheumatic endocarditis
I02.9 Rheumatic chorea witho...
ARF is an autoimmune, inflammatory disease that follows a GAS pharyngeal infection and affects multiple organ systems, most notably, the heart.
Modified Jones criteria now delineate bet...
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<bold>FIG. 79.1.</bold> A: Mitral valve from a patient with mitral stenosis from rheumatic fever (viewed from atrium). Notice the thickened calcific leaflets and thickened chordae tendineae compared with a normal mitral valve (B). (Courtesy of W.D. Edwards, M.D., Mayo Clinic.)
<bold>FIG. 79.1.</bold> A: Mitral valve from a patient with mitral stenosis from rheumatic fever (viewed from atrium). Notice ...
<bold>FIG. 79.2.</bold> A: Erythema marginatum in an adult with rheumatic fever. B: Closer view of rash. (Courtesy of P. Witman, M.D., Mayo Clinic.)
<bold>FIG. 79.2.</bold> A: Erythema marginatum in an adult with rheumatic fever. B: Closer view of rash. (Courtesy of P. Witma...