Revised Jones Criteria for rheumatic fever
Revised Jones Criteria is used as a guidance to diagnose a rheumatic fever. It has been published by the American Heart of Association. In order to diagnose rheumatic fever, there must be evidence of recent streptococcus infection plus 2 major criteria or 1 major + 2 minor criterion.
Evidence of streptococcal infection:
• Recent streptococcal infection
• History of scarlet fever
• Positive throat swab
• Increase in ASOT > 200u/mL
• Increase in DNase B titre
Major criteria:
• Carditis – tachycardia, murmurs (mitral or aortic regurgitation, Carey Coombs’ murmur), pericardial rub, congestive cardiac failure, cardiomegally, conductions defects (45-70%). An apical systolic murmur maybe the only sign.
• Arthritis- A migratory, ‘flitting’ polyarthritis; usually affects larger joints (75%)
• Subcutaneous nodules – small, mobile painless nodules on extensor surfaces of joints and spine (2-20%)
• Erythema marginatum – Geographical-type rash with red, raised edges and clear centre; occurs mainly on trunk, thighs, arms in 2-20%
• Sydenham’s chorea (St Vitus’ dance) – occurs late in 10%. Unilateral or bilateral involuntary semi-purposeful movements. May be preceded by emotional liability and uncharacteristic behavior.
Minor criteria:
• Fever
• Raised ESR or CRP
• Arthralgia (but not if arthritis is one of the major criteria)
• Prolonged P-R interval (but not if carditis is the major criteria)
• Previous rheumatic fever or rheumatic heart disease
Other relevant topic:
Reference;
1. Fred F Ferry et al. Ferri’s Clinical Advisor Instant Diagnosis and Treatment 2008. Mosby Elsevier.
2. Murray Longmore et al. Oxford Handbook of Clinical Medicine. 7th edition. 2008. Oxford.
Tags: arthritis, carditis, Revised Jones Criteria, rheumatic fever, streptococcal infection
Technorati Tags: arthritis, carditis, Revised Jones Criteria, rheumatic fever, streptococcal infection
have a child who is recovering from having a high fever for many days, scarlatina and strep. My child is older,but not able to verbally explain all her symptoms well. If rheumatic fever is a possible symptom of scarlet fever/strep, etc…would a person be complaining about pain in their joints at the time? Would it be very obvious that a rheumatic fever is different from a regular fever?
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