Acute rheumatic fever continues to cause a large burden of mortality and morbidity in developing countries. It is less common in developed countries but continues to be seen in indigenous communities and during outbreaks.
It is caused by an autoimmune process following infection with group A streptococci.
No single test can diagnose acute rheumatic fever. Diagnosis is clinical and relies on the Jones criteria.
The 5 major manifestations of acute rheumatic fever are carditis, arthritis, chorea, erythema marginatum, and subcutaneous nodules, of which the most common are carditis and arthritis.
The Jones criteria were revised in 2015 to include separate criteria for low-risk and moderate- to high-risk populations.
While all other manifestations of acute rheumatic fever resolve without sequelae, carditis can lead to chronic rheumatic heart disease.
No treatment has been shown to alter the progression of acute rheumatic fever to chronic rheumatic heart disease.
Secondary prophylaxis can improve the prognosis of established rheumatic valvular disease.
Acute rheumatic fever is an autoimmune disease following infection with group A streptococci. It affects multiple systems including the joints, the brain, the skin, and the heart. Only the effects on the heart can lead to permanent illness; chronic changes to the valves of the heart are referred to as rheumatic heart disease. Acute rheumatic fever tends to recur, leading to cumulative damage to the cardiac valvular tissue.
Paediatric Infectious Diseases Physician
Centre for International Child Health
Department of Paediatrics
University of Melbourne
Royal Children's Hospital
ACS declares that he has no competing interests.
Telethon Institute for Child Health Research
JC declares that he has no competing interests.
Professor of Pediatrics
Division of Pediatric Cardiology
Faculty of Medicine
University of Alexandria
El Shatby Children's Hospital
SZ declares that she has no competing interests.
Paediatric Cardiologist/Interventional Cardiologist
Paediatric and Congenital Cardiac Services
Green Lane Clinical Services
Starship Children's Hospital
NW declares that he has no competing interests.
Assistant Professor of Pediatrics
Medical University of South Carolina
AS declares that she has no competing interests.
Use of this content is subject to our disclaimer