La malattia reumatica nel 2016

Acute Rheumatic Fever (ARF) continues to be a major health hazard in most developing countries as well as sporadically in developed economies. Despite reservations about the utility, Doppler echocardiographic studies have identified a massive burden of ARF suggesting the inadequacy of the Jones’ criteria, which have recently been updated for the first time since 1992 by including echocardiographic evidence of carditis and a wider spectrum of joint manifestations as major criteria. Diagnosis of ARF is based on the presence of documented preceding Group A Streptococcal (GAS) infection, in addition to the presence of two major manifestations or one major and two minor manifestations of the revised Jones criteria. Without documentation of antecedent GAS infection, the diagnosis is much less likely except in a few rare scenarios. This issue focuses on the clinical evaluation and treatment of patients with ARF by offering a thorough review of the literature on diagnosis and recommendations about appropriate treatment.