Rheumatic fever

Diagnosis, management and secondary prevention of acute rheumatic fever.

Rheumatic fever is an autoimmune response to Group A Streptococcus (GAS) infection of the upper respiratory tract.

The autoimmune response may result in carditis or inflammation of the mitral and/or aortic valves. When the inflammation leads to permanent damage of the valves the individual has rheumatic heart disease (RHD).

Appropriate identification and antibiotic treatment of sore throats in high-risk populations will usually eliminate group A streptococcus and prevent individual cases of acute rheumatic fever. Sore throat management (primary prevention) is covered in the short course Sore throat management.

Learning objectives:

• Know the clinical features of acute rheumatic fever.
• Understand the principles of the initial management of acute rheumatic fever.
• Know the secondary prevention required for acute rheumatic fever.
• Be aware of strategies to improve the adherence of secondary prevention.

Acknowledgements

This material was written by Dr Karen Falloon PhD, MBChB, FRNZCGP.