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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.

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Presentation on theme: "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."— Presentation transcript:

1 REVISED JONES CRITERIA 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.

2 MAJOR MANIFESTATIONS: Carditis Polyarthritis Chorea Erythema Marginatum Subcutaneous Nodules MINOR MANIFESTATIONS: Clinical: fever, polyarthralgia Labs: elevated ESR, C-reactive protein (Acute Phase Reactants) ECG: prolonged P-R interval REVISED JONES CRITERIA WHO Criteria for the Diagnosis of RF and RHD 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, 17 th ed.

3 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 REVISED JONES CRITERIA WHO Criteria for the Diagnosis of RF and RHD Harrison’s Principles of Internal Medicine, 17 th ed.

4 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. REVISED JONES CRITERIA WHO Criteria for the Diagnosis of RF and RHD Harrison’s Principles of Internal Medicine, 17 th ed.

5 “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) REVISED JONES CRITERIA WHO Criteria for the Diagnosis of RF and RHD Harrison’s Principles of Internal Medicine, 17 th ed.


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