Diagnosis and Management of Acute Rheumatic Fever

Diagnostic Criteria and Laboratory Investigations

Acute rheumatic fever (ARF) is an inflammatory condition triggered by Group A Streptococcus infection. It primarily affects the joints, heart, skin, and central nervous system.

Diagnostic Criteria

Diagnosis is based on the revised Jones Criteria:

• Major Criteria: Carditis, Polyarthritis, Chorea, Erythema marginatum, Subcutaneous nodules
• Minor Criteria: Fever, Arthralgia, Elevated acute phase reactants, Prolonged PR interval on ECG

Laboratory Investigations

Important laboratory tests for ARF include:

• ASO titers to detect prior Group A Streptococcus infection
• Throat culture or rapid antigen test for streptococcal identification
• ESR and CRP for inflammation markers

Management

Treatment involves:

• Antibiotic therapy with penicillin to eradicate streptococcal infection
• Aspirin or corticosteroids for inflammation control
• Long-term prophylaxis with penicillin to prevent recurrent episodes

Conclusion

Early detection and appropriate management of acute rheumatic fever are essential in preventing rheumatic heart disease, a significant long-term complication.