Rheumatic Fever
1997 Case Definition
The 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 description
An 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 classification
Confirmed: 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).
Comment
Supporting 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.
References
14. American Heart Association. Jones criteria (revised) for guidance in
the diagnosis of rheumatic fever. Circulation 1984;69:204A-8A.
Printable
Version |
.gif){kind=spacer}
