Key words: Acute rheumatic fever, Group A streptococcal infection, Jones’ criteria
Acute Rheumatic Fever (ARF) continues to be a major health hazard in most developing
countries as well as sporadically in developed economies. Despite reservations about
the utility, Doppler echocardiographic studies have identified a massive burden of ARF
suggesting the inadequacy of the Jones’ criteria, which have recently been updated for
the first time since 1992 by including echocardiographic evidence of carditis and a wider
spectrum of joint manifestations as major criteria. Diagnosis of ARF is based on the
presence of documented preceding Group A Streptococcal (GAS) infection, in addition
to the presence of two major manifestations or one major and two minor manifestations
of the revised Jones criteria. Without documentation of antecedent GAS infection, the
diagnosis is much less likely except in a few rare scenarios. This issue focuses on the clinical
evaluation and treatment of patients with ARF by offering a thorough review of the
literature on diagnosis and recommendations about appropriate treatment.
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