Rheumatic fever in a high incidence population: the importance of monoarthritis and low grade fever.
Aims: To describe the clinical features of rheumatic fever and to assess the Jones criteria in a population and setting similar to that in many developing countries.Methods: The charts of 555 cases of confirmed acute rheumatic fever in 367 patients (97% Aboriginal) and more than 200 possible rheumat...
| Published in: | Archives of Disease in Childhood Vol. 85; no. 3; pp. 223 - 228 |
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| Main Authors: | , , , |
| Format: | research tables/charts Journal Article |
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BMJ Publishing Group
Sep2001
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107078140&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107078140 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039888 6PU jtl: Archives of Disease in Childhood issn: 00039888 maglogo: N pubinfo: dt: Sep2001 vid: 85 iid: 3 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 107078140 107078140 NLM11517105 2001115452 10.1136/adc.85.3.223 NLM11517105 107078140 ppf: 223 ppct: 5 formats: tig: atl: Rheumatic fever in a high incidence population: the importance of monoarthritis and low grade fever. aug: au: Carapetis JR Currie BJ Carapetis, J R Currie, B J affil: University of Melbourne Dept of Paediatrics, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic 3052, Australia sug: subj: Rheumatic Fever Symptoms Fever Etiology Aboriginal Australians Australia Arthritis Etiology Retrospective Design Descriptive Statistics Record Review Convenience Sample Data Analysis Software Chi Square Test Confidence Intervals Relative Risk Fisher's Exact Test Australia Aboriginal Australians Child, Preschool Child Adolescence Adult Funding Source Human Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years ab: Aims: To describe the clinical features of rheumatic fever and to assess the Jones criteria in a population and setting similar to that in many developing countries.Methods: The charts of 555 cases of confirmed acute rheumatic fever in 367 patients (97% Aboriginal) and more than 200 possible rheumatic fever cases from the tropical "Top End" of Australia's Northern Territory were reviewed retrospectively.Results: Most clinical features were similar to classic descriptions. However, monoarthritis occurred in 17% of confirmed non-chorea cases and 35% of unconfirmed cases, including up to 27 in whom the diagnosis was missed because monoarthritis is not a major manifestation. Only 71% and 25% of confirmed non-chorea cases would have had fever using cut off values of 38 degrees C and 39 degrees C, respectively. In 17% of confirmed non-chorea cases, anti-DNase B titres were raised but antistreptolysin O titres were normal. Although features of recurrences tended to correlate with initial episodes, there were numerous exceptions.Conclusions: Monoarthritis and low grade fever are important manifestations of rheumatic fever in this population. Streptococcal serology results may support a possible role for pyoderma in rheumatic fever pathogenesis. When recurrences of rheumatic fever are common, the absence of carditis at the first episode does not reliably predict the absence of carditis with recurrences. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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