Jones Criteria for Acute Rheumatic Fever Diagnosis
Diagnoses acute rheumatic fever based on major and minor criteria.
Note: As of 2015, the Jones Criteria have been updated to include the use of doppler echocardiography. See AHA's update.
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Cases of isolated chorea, indolent carditis, or recurrent episodes of rheumatic fever are more suggestive of rheumatic fever regardless of the presence of other Jones Criteria. In these scenarios, ARF is the presumptive diagnosis until proven otherwise.
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Remember that arthralgia (joint pain) is distinct from arthritis (objective findings related to inflammation such as warmth, erythema, or swelling).
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Echocardiogram is key in the evaluation of ARF, and should be performed in all cases of confirmed or suspected ARF.
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If the diagnosis of ARF has been made without evidence of structural heart disease, an echocardiogram and cardiology consult are still recommended.
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Household members living with a patient with confirmed ARF should be screened and treated for GAS infection/colonization when appropriate.
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A penicillin antibiotic is typically the first line treatment for ARF (oral penicillin V or intramuscular penicillin G); amoxicillin can also be considered.