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1997 Case DefinitionThe 1997 case definition appearing on this page was previously published in the 1990 MMWR Recommendations and Reports titled Case Definitions for Public Health Surveillance [MMWR 1990;39(RR13)] (available at http://www.cdc.gov/mmwr/preview/mmwrhtml/00025629.htm). Thus, the 1990 and 1997 versions of the case definition are identical. Clinical descriptionAn inflammatory illness that occurs as a delayed sequela of group A streptococcal infection Major criteria: carditis, polyarthritis, chorea, subcutaneous nodules, and erythema marginatum Minor criteria: a) previous rheumatic fever or rheumatic heart disease; b) arthralgia; c) fever; d) elevated erythrocyte sedimentation rate, positive C-reactive protein, or leukocytosis; and e) prolonged PR interval on an electrocardiogram Laboratory criteria for diagnosis
Case classificationConfirmed: an illness characterized by a) two major criteria or one major and two minor criteria (as described in Clinical Description) and b) supporting evidence of preceding group A streptococcal infection (14). CommentSupporting evidence to confirm streptococcal infection includes increased antistreptolysin-O or other streptococcal antibodies, throat culture positive for group A streptococcus, or recent scarlet fever. The absence of supporting evidence of preceding streptococcal infection should make the diagnosis doubtful, except in Sydenham chorea or low-grade carditis when rheumatic fever is first discovered after a long latent period from the antecedent infection. References14. American Heart Association. Jones criteria (revised) for guidance in the diagnosis of rheumatic fever. Circulation 1984;69:204A-8A. |
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