+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested



Le Journal Medical Libanais. Lebanese Medical Journal 63(4): 198-202

The main aim of this study is to evaluate the significance of several clinical and laboratory findings presented by a large number of pediatric patients who were suspected to have acute rheumatic fever (ARF) by physicians who ordered echocardiogram for confirmation and for avoiding overuse of unnecessary antibiotics. These suspecting reasons include elevated ASO titers and recurrent tonsillitis. Another aim is to stress the role of Doppler echocardiogram in confirming the diagnosis of ARF by detecting rheumatic heart disease (RHD) in suspected cases. 401 patients were registered in the National Registry of the Pediatric and Congenital Heart Disease (RNCPC) from April 1, 2002 until the end of March 2013 as suspected cases of ARF. The clinical reasons that brought suspicion are discussed and evaluated in accordance to modified Jones criteria. The patients are distributed into two groups: 1) confirmed ARF and 2) different diagnosis. All patients underwent echocardiogram. Patients came from different geographic areas and were referred by a variety of physicians. 48 patients out of 401 suspected cases turned to have confirmed ARF (12%). In this group, the predominant suspecting reasons are reported as heart murmur in 29/48 (60.4%), arthritis in 28/48 (58.3%), arthralgia with reduced physical activity in 15/48 (31%) and chorea in 5/48 (10%). In the different diagnosis group with a high ASO titer 174/353 (49.3%), isolated arthralgia 91/353 (25.8%) and combined elevated ASO with arthralgia in 44/353 (12.5%) were the predominant suspecting reasons. Doppler echocardiography could detect 38/48 cases of active carditis and subclinical carditis (SCC). Heart murmur, arthritis, arthralgia with reduced physical activity and chorea are the main clinical reasons that lead to suspicion in the ARF group. High ASO titers, arthralgia, and combination of high ASO titers with arthralgia are the main presenting symptoms in the group with a different diagnosis. We concluded that elevated ASO titer and normal ESR with arthralgia not reducing physical activity can exclude ARF. Doppler echocardiography is found to be a gold standard key to confirm acute rheumatic heart disease and ARF.

(PDF emailed within 1 workday: $29.90)

Accession: 057851986

Download citation: RISBibTeXText

PMID: 26821402

Related references

An epidemiological study to assess the true incidence and prevalence of rheumatic heart disease and acute rheumatic fever in New Caledonian school children. Journal of Paediatrics and Child Health 52(7): 739-744, 2016

Community resources for the diagnosis and acute care of patients with rheumatic fever. Study group on rheumatic fever and rheumatic heart disease. Journal of the American Osteopathic Association 71(2): 151-156, 1971

On the prognosis and natural history of acute rheumatic fever and rheumatic fever and rheumatic heart disease A study based upon a 25-year material in a Swedish town served by a single hospital. 1961

Early ambulation in the treatment of acute rheumatic fever. A controlled study in children with acute rheumatic fever treated with prednisone. American Journal of Diseases of Children 115(5): 557-569, 1968

CLINICAL pathologic conference; rheumatic pneumonia; acute rheumatic fever; acute rheumatic disease, pancarditis, with involvement of the mitral and aortic valves. Missouri Medicine 47(9): 675-679, 1950

Acute rheumatic fever in adults: case report together with an analysis of 25 patients with acute rheumatic fever. Rheumatology International 29(9): 1041-1045, 2008

Acute abdomen in familial Mediterranean fever. False or true surgical abdomen?. Presse Medicale 15(30): 1422-1422, 1986

What is the true frequency of carditis in acute rheumatic fever? A prospective clinical and Doppler blind study of 56 children with up to 60 months of follow-up evaluation. Pediatric Cardiology 29(6): 1048-1053, 2008

Trends in acute rheumatic fever. The Barbados experience. Journal of Tropical Pediatrics 40(2): 94-96, 1994

Assessment of Primary Health Care in the Treatment of Tuberculosis in a Brazilian Locality of the International Triple Frontier. Open Nursing Journal 11: 124-134, 2017

Are all recurrences of "pure" Sydenham chorea true recurrences of acute rheumatic fever?. Journal of Pediatrics 107(6): 867-872, 1985

Streptococcal disease and rheumatic fever in Air Force recruits. I. Epidemiology and clinical picture of acute rheumatic fever. A.M.A. Archives of Internal Medicine 100(4): 604-614, 1957

Studies on the pathogenesis of rheumatic fever; the antistreptolysin titre in acute tonsillitis, in patients admitted for tonsillectomy, in rheumatic fever and in control groups. New Zealand Medical Journal 49(270): 118-126, 1950

Acute rheumatic fever experience at a large urban hospital. Saudi Medical Journal 12(6): 464-466, 1991

Recurrence of rheumatic fever and valvular diseases--etiology of rheumatic fever, rheumatic carditis and recurrent rheumatic fever. Nihon Rinsho. Japanese Journal of Clinical Medicine 37(8): 3082-3102, 1979