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REVISED JONES CRITERIA 2002-2003 WHO Criteria for the Diagnosis of RF and RHD

REVISED JONES CRITERIA 2002-2003 WHO Criteria for the Diagnosis of RF and RHD. Includes preceding streptococcal type A infection and a combination of major and minor clinical manifestations. Harrison’s Principles of Internal Medicine, 17 th ed.

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REVISED JONES CRITERIA 2002-2003 WHO Criteria for the Diagnosis of RF and RHD

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  1. REVISED JONES CRITERIA2002-2003 WHO Criteria for the Diagnosis of RF and RHD Includes preceding streptococcal type A infection and a combination of major and minor clinical manifestations Harrison’s Principles of Internal Medicine, 17th ed.

  2. REVISED JONES CRITERIA2002-2003 WHO Criteria for the Diagnosis of RF and RHD MAJOR MANIFESTATIONS: • Carditis • Polyarthritis • Chorea • ErythemaMarginatum • Subcutaneous Nodules MINOR MANIFESTATIONS: • Clinical: fever, polyarthralgia • Labs: elevated ESR, C-reactive protein (Acute Phase Reactants) • ECG: prolonged P-R interval • SUPPORTING EVIDENCE OF A PRECEDING STREPTOCOCCAL INFECTION W/IN THE LAST 45 DAYS: • Elevated or rising anti-streptolysin O or other streptococcal antibody, or • (+) Throat culture, or • Rapid antigen test for group A streptococcus Harrison’s Principles of Internal Medicine, 17th ed.

  3. REVISED JONES CRITERIA2002-2003 WHO Criteria for the Diagnosis of RF and RHD DIAGNOSTIC CATEGORIES Primary Episode of Rheumatic Fever 2 Major OR 1 Major + 2 Minor manifestations Plus evidence of preceding group A streptococcal infection Recurrent attack of RF in a patient without established RHD 2 Major OR 1 Major + 2 Minor manifestations Plus evidence of preceding group A streptococcal infection Recurrent attack of RF in a patient with established RHD 2 Minor manifestations Plus evidence of preceding group A streptococcal infection Harrison’s Principles of Internal Medicine, 17th ed.

  4. REVISED JONES CRITERIA2002-2003 WHO Criteria for the Diagnosis of RF and RHD DIAGNOSTIC CATEGORIES Rheumatic Chorea Insidous onset rheumatic carditis Other major manifestations or evidence of group A strep. infection not required • Infective endocarditis should be excluded. Chronic valve lesions of RHD Do not require any other criteria to be diagnosed as having rheumatic heart disease • Congenital heart disease should be excluded. Harrison’s Principles of Internal Medicine, 17th ed.

  5. REVISED JONES CRITERIA2002-2003 WHO Criteria for the Diagnosis of RF and RHD “Probable Rheumatic Fever” • with polyarthritis (or with only polyarthralgia or monoarthritis) and with several (3 or more) other minor manifestations, plus evidence of recent group A streptococcal infection. • may later turn out to be rheumatic fever • advise regular secondary prophylaxis, follow up closely and do regular heart examination (esp. in vulnerable age groups in high incidence settings) Harrison’s Principles of Internal Medicine, 17th ed.

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