Acute rheumatic fever (ARF) is an autoimmune, inflammatory response to infection with group A Streptococcus (GAS) that affects multiple organ systems.
Untreated acute disease can lead...
2015 Revised Jones Criteria and lab evidence of preceeding GAS infection are used for diagnosis.
Initial ARF: 2 major OR 1 major + 2 minor
Recurrent ARF: 2 major OR 1 major + 2 minor OR 3 mino...
Antibiotic
Anti-inflammatory agent (aspirin or naproxen)
Manage other manifestations as indicated (e.g., chorea, dysrhythmia, carditis, or heart failure).
Er...
Secondary prophylaxis: antibiotic therapy from time of diagnosis until at least age 21 years, or 5 years after diagnosis (whichever comes later)
Indefinite prophyl...
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 GAS pharyngitis or impetigo and affects multiple organ systems, including the heart.
Modified Jones criteria delineate between lo...
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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...