Rheumatic fever: update on the Jones criteria according to the American Heart Association review – 2015

Abstract

Rheumatic fever is still currently a prevalent disease, especially in developing countries. Triggered by a Group A β-hemolytic Streptococcus infection, the disease may affect genetically predisposed patients. Rheumatic carditis is the most important of its clinical manifestations, which can generate incapacitating sequelae of great impact for the individual and for society. Currently, its diagnosis is made based on the Jones criteria, established in 1992 by the American Heart Association. In 2015, the AHA carried out a significant review of these criteria, with new diagnostic parameters and recommendations. In the present study, the authors perform a critical analysis of this new review, emphasizing the most relevant points for clinical practice.

Acute rheumatic fever in children: Experience at the hospital Hassan II of Fez, Morocco

“…Elevated levels of ESR (> 60 mm in the first hour) and C-reactive proteins (> 3 mg/L) observed in this study has also been supported by other studies (11,21,23,26).…”

“…The major ones being: polyarthritis, carditis, chorea, subcutaneous nodule. While the minor criteria consisted of arthralgia, fever, high ESR and/or CRP, and prolonged PR interval (11). For the acute rheumatic fever, diagnosis is recorded if 2 majors or 1 major criterion and 2 minor criteria associated with evidence of recent streptococcal infection: ASO elevated.…”

“…For the acute rheumatic fever, diagnosis is recorded if 2 majors or 1 major criterion and 2 minor criteria associated with evidence of recent streptococcal infection: ASO elevated. 11…”

Acute rheumatic fever in a 61-year-old patient

“…However, it has been described considering mostly the presentation of first ARF events in children and young adults . [4][5][6] . Recurrent attacks in older adults can often present with atypical clinical features, considering the classical parameters of the Jones criteria 7,8 .…”

A Case Report of Acute Cardiac Failure in a Child: An Atypical Presentation Acute Rheumatic Fever; A Challenging Diagnosis

“…Acute rheumatic fever (ARF) is an autoimmune response which occurs secondary to a pharyngeal infection with Group A Streptococcus (GAS) [1][2][3][4][5], classically streptococcus pyogenes [6][7][8]. This response typically occurs within two to four weeks of the primary GAS infection and predominantly affects 5-14 year olds [9,10].…”