What is necessary to diagnose rheumatic fever?
The clinical description of rheumatic fever is an inflammatory illness that occurs as a delayed sequela of GAS upper respiratory infection. The case definition for rheumatic fever is as follows: Major Criteria for diagnosis: carditis, polyarthritis, chorea, subcutaneous nodules, and erythema marginatum; Minor Criteria for diagnosis: 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. A case of rheumatic fever is confirmed when there is an illness characterized by two major criteria or one major and two minor criteria (as described in the clinical description), and by supporting evidence of preceding GAS infection. [Comments: Supporting evidence to confirm streptococcal infection includes increased anti-streptolysin-O or other streptococcal antibodies, throat culture positive for GAS, or recent scarlet fever. The abse
