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jones criteria for rheumatic fever

Himanshu Pathak, Tarnya Marshall
A 35-year-old man presented with polyarthritis and constitutional symptoms, and a recent history of multiple tick bites and skin rash on trekking holiday. He did not respond to oral doxycycline and cephalexine for presumed Lyme's disease. Further investigation confirmed strongly positive streptococcal serology. There was absence of clinical or echocardiography evidence of heart involvement and immunological screening for inflammatory arthritis was negative. In the absence of other major Jones criteria for acute rheumatic fever, besides polyarthritis and the serological evidence of a recent streptococcal infection, a diagnosis of post-streptococcal reactive arthritis (PSRA) was also made...
2016: BMJ Case Reports
Andrea Beaton, Jonathan Carapetis
The Jones criteria has longed served as the primary guideline for diagnosing acute rheumatic fever (ARF). However, since the first iteration in 1944, the global epidemiology of ARF and our knowledge regarding the variability of its presentation have changed. In 2015, the American Heart Association took on an ambitious and successful revision, which accounts for these changes. For the first time, the criteria consider the risk within a population and offer two separate diagnostic pathways that prioritise specificity among those at low risk and sensitivity among those at moderate/high risk...
2015: Heart Asia
Binoy Shankar, Euden Bhutia, Dinesh Kumar
A 13-year-old boy presented with vague musculoskeletal pain and involvement of multiple small and large joints along with axial skeleton for the last 3 years, poorly responsive to aspirin. However, on account of presence of carditis and fulfilment of Jones criteria, a diagnosis of acute rheumatic fever (ARF) with atypical arthritis was made. We report this case to break the myth and sensitize pediatricians and rheumatologists to keep the possibility of atypical articular presentations, as in our case, in patients with ARF and prevent delayed diagnosis and treatment...
May 2016: Annals of Pediatric Cardiology
Jonathan R Carapetis, Andrea Beaton, Madeleine W Cunningham, Luiza Guilherme, Ganesan Karthikeyan, Bongani M Mayosi, Craig Sable, Andrew Steer, Nigel Wilson, Rosemary Wyber, Liesl Zühlke
Acute rheumatic fever (ARF) is the result of an autoimmune response to pharyngitis caused by infection with group A Streptococcus. The long-term damage to cardiac valves caused by ARF, which can result from a single severe episode or from multiple recurrent episodes of the illness, is known as rheumatic heart disease (RHD) and is a notable cause of morbidity and mortality in resource-poor settings around the world. Although our understanding of disease pathogenesis has advanced in recent years, this has not led to dramatic improvements in diagnostic approaches, which are still reliant on clinical features using the Jones Criteria, or treatment practices...
2016: Nature Reviews. Disease Primers
Pandiarajan Vignesh, Avinash Sharma
No abstract text is available yet for this article.
May 3, 2016: Indian Journal of Pediatrics
Ayşe Güler Eroğlu
In the final Jones criteria, different diagnostic criteria were established for the diagnosis of acute rheumatic fever for low risk and moderate-high risk populations. Turkey was found to be compatible with moderate-high risk populations as a result of regional screenings performed in terms of acute rheumatic fever and rheumatic heart disease. The changes in the diagnostic criteria for low-risk populations include subclinical carditis found on echocardiogram as a major criterion in addition to carditis found clinically and a body temperature of 38...
March 2016: Türk Pediatri Arşivi
Najwa Jawhar, Imad Chami, Zakhia Saliba, Ghassan Chehab
OBJECTIVES: 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...
October 2015: Le Journal Médical Libanais. the Lebanese Medical Journal
S J Carlus, A M Abdallah, L V K S Bhaskar, M M Morsy, G S Al-Harbi, A H Al-Mazroea, K M Al-Harbi
OBJECTIVE: Rheumatic heart disease (RHD) is a serious complication of rheumatic fever (RF). Plasma homocysteine (Hcy) levels are increased in RHD patients. MTHFR catalyzes the irreversible conversion of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate and plays a vital role in Hcy metabolism. We hypothesize that the MTHFR C677T polymorphism is associated with a risk of RHD. PATIENTS AND METHODS: Eighty-six patients with RHD and 130 matched controls without a history of RHD were eligible for the study...
2016: European Review for Medical and Pharmacological Sciences
Rajeev Bhardwaj, Arvind Sood
INTRODUCTION: Rheumatic heart disease (RHD) is still a common cause of morbidity and mortality in India. Rheumatic fever commonly occurs between 5-15 yrs of age. Rheumatic activity is a common cause of deterioration of symptoms in a stable or undiagnosed case of RHD. MATERIAL AND METHODS: 41 consecutive patients of acute rheumatic activity were studied. Presenting symptoms were noted. Physical examination was done for major and minor Jone's criteria. Detailed cardiac examination was done...
April 2015: Journal of the Association of Physicians of India
Yusuke Oba, Hiroaki Watanabe, Yoshioki Nishimura, Shuichi Ueno, Takao Nagashima, Yasushi Imai, Masahisa Shimpo, Kazuomi Kario
A 45-year-old hypertensive Japanese woman presented with epigastric pain on inspiration, fever, complete atrioventricular block and polyarthritis. Her antistreptolysin O levels were markedly elevated. A diagnosis of rheumatic fever was made according to the modified Jones criteria. She was prescribed loxoprofen sodium, which was partially effective for her extracardiac clinical symptoms. However, she had syncope due to complete atrioventricular block with asystole longer than 10 seconds. Consequently, we implanted a permanent pacemaker...
2015: International Heart Journal
P Gapu, M Bwakura-Dangarembizi, G Kandawasvika, D Kao, C Bannerman, J Hakim, J A Matenga
BACKGROUND: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain significant causes of morbidity and mortality in resource-limited settings. In Zimbabwe ARF/RHD characteristics have not been systematically documented. OBJECTIVES: To document cases of ARF/RHD among children presenting at referral hospitals in Harare, Zimbabwe, determine their clinical and echocardiographic characteristics, and identify opportunities for improving care. METHODS: A cross-sectional survey was carried out in which consecutive children aged 1 - 12 years presenting with ARF/RHD according to the 2002/3 World Health Organization modified Jones criteria were enrolled...
May 2015: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Antoinette Cilliers, Alma J Adler, Haroon Saloojee
BACKGROUND: Rheumatic heart disease remains an important cause of acquired heart disease in developing countries. Although prevention of rheumatic fever and management of recurrences have been well established, optimal management of active rheumatic carditis remains unclear. This is an update of a review published in 2003, and previously updated in 2009 and 2012. OBJECTIVES: To assess the effects, both harmful and beneficial, of anti-inflammatory agents such as aspirin, corticosteroids and other drugs in preventing or reducing further valvular damage in patients with acute rheumatic fever...
2015: Cochrane Database of Systematic Reviews
Michael H Gewitz, Robert S Baltimore, Lloyd Y Tani, Craig A Sable, Stanford T Shulman, Jonathan Carapetis, Bo Remenyi, Kathryn A Taubert, Ann F Bolger, Lee Beerman, Bongani M Mayosi, Andrea Beaton, Natesa G Pandian, Edward L Kaplan
BACKGROUND: Acute rheumatic fever remains a serious healthcare concern for the majority of the world's population despite its decline in incidence in Europe and North America. The goal of this statement was to review the historic Jones criteria used to diagnose acute rheumatic fever in the context of the current epidemiology of the disease and to update those criteria to also take into account recent evidence supporting the use of Doppler echocardiography in the diagnosis of carditis as a major manifestation of acute rheumatic fever...
May 19, 2015: Circulation
Jose L Aguirre, Margarita Jurado, Mateo Porres-Aguilar, Cristina Olivas-Chacon, Mateo Porres-Muñoz, Debabrata Mukherjee, Juan Taveras
Acute myocarditis can be induced by various concomitant disease processes including infections. Most of these cases are viral in origin; however, bacterial infections are also implicated to a lesser degree. Group A streptococcus is a frequent culprit in bacterial-induced myocarditis. Its diagnosis is suspected by the presence of signs and symptoms of rheumatic fever as established by the Jones criteria. The development and refinement of current diagnostic tools has improved our ability to identify specific pathogens...
April 2015: Proceedings of the Baylor University Medical Center
M Mostafa Zaman, Sohel Reza Choudhury, Shafiqur Rahman, Jasimuddin Ahmed
BACKGROUND: Recent prevalence data on rheumatic fever (RF) and rheumatic heart disease (RHD) are lacking in Bangladeshi population. AIM: We have done this national level cross-sectional survey to determine the prevalence of RF and RHD in Bangladeshi children. METHODS: Samples were drawn from three out of seven divisions of Bangladesh from both urban and rural areas. Trained and experienced enumerators visited households to suspect cases of RF or RHD in 5-19 years children by asking structured questions on symptoms and signs of RF and RHD (n = 56,827)...
January 2015: Indian Heart Journal
Raakhi M Mistry, Diana Lennon, Matthew J Boyle, Karel Chivers, Chris Frampton, Ross Nicholson, Haemish Crawford
INTRODUCTION: Joint pain and raised inflammatory markers are features of both acute rheumatic fever (ARF) and septic arthritis, often posing a diagnostic challenge to clinicians. Important differences in the presenting serological inflammatory marker profile may assist patient diagnosis, however, as clinical experience suggests that ARF is associated with a higher erythrocyte sedimentation rate (ESR), whereas other serological markers may be similarly elevated in these 2 conditions. OBJECTIVE: The goal of this study was to determine the diagnostic value of serological inflammatory markers and white cell count (WCC) in children presenting with acute joint pain secondary to ARF or septic arthritis...
April 2015: Journal of Pediatric Orthopedics
Hayrullah Alp, Tamer Baysal, Hakan Altın, Zehra Karataş, Sevim Karaarslan
BACKGROUND: Simple electrocardiogram (ECG) markers have been used to evaluate conduction times. Acute rheumatic fever (ARF) is an autoimmune disease that affects these conduction times. The aim of this prospective long-term follow-up study was to evaluate QT, QTc and P-wave dispersions in children with ARF and chronic rheumatic heart disease (CRHD). METHODS: Sixty-four patients with ARF, 33 patients with CRHD and 41 healthy, age- and sex-matched control subjects were included in the study...
October 2014: Pediatrics International: Official Journal of the Japan Pediatric Society
J Oliver, N Pierse, M G Baker
Rheumatic fever (RF) is an important public health problem in New Zealand (NZ). There are three sources of RF surveillance data, all with major limitations that prevent NZ generating accurate epidemiological information. We aimed to estimate the likely RF incidence using multiple surveillance data sources. National RF hospitalization and notification data were obtained, covering the periods 1988-2011 and 1997-2011, respectively. Data were also obtained from four regional registers: Wellington, Waikato, Hawke's Bay and Rotorua...
January 2015: Epidemiology and Infection
Pushpa Shivaram, Molla Imaduddin Ahmed, Pramod Theetha Kariyanna, Harika Sabbineni, Uma Mahesh R Avula
RATIONALE: Doppler echocardiography has been demonstrated to be accurate in diagnosing valvular lesions in rheumatic heart disease (RHD) when compared to clinical evaluation alone. OBJECTIVE: To perform Doppler echocardiography in children clinically diagnosed by the Jones criteria to have acute rheumatic fever (ARF), and to then compare the effectiveness of echo in detecting single/multi-valvular lesions with that of the initial clinical evaluation. METHODS AND RESULTS: We enrolled 93 children who were previously diagnosed with ARF by clinical examination...
2013: PloS One
Nigel J Wilson, Lesley Voss, Johan Morreau, Joanna Stewart, Diana Lennon
AIM: The aim of the study was to compare utilisation of the New Zealand guidelines for the diagnosis of acute rheumatic fever (ARF) compared to the American Heart Association Jones criteria in a cohort of children METHOD: Retrospective review of 79 consecutive hospital diagnosed cases of ARF referred for secondary penicillin prophylaxis. The 2006 New Zealand guidelines for ARF were applied to the cohort and the diagnostic classification compared to classification using the American Heart Association 1992 Jones criteria...
August 2, 2013: New Zealand Medical Journal
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