[The clinical observation and follow-up of acute rheumatic fever]

There were 15 patients under 15 years of age with cases of acute rheumatic fever diagnosed by revised Jones criteria admitted to pediatric department, Chang Gung Memorial Hospital of Kaohsiung from Jan. 1986 through Dec. 1989. There were 11 boys and 4 girls. The age of onset was more commonly between 13 and 15 years old. Carditis was the most common clinical presentation, noted in 13 cases. Eleven cases had valvular involvement: mitral regurgitation (MR) and mitral valve prolapse (MVP), 5 cases; MR and aortic regurgitation (AR), 4 cases; MR, 1 case; and MVP, 1 case. One case with MR + AR also suffered transient acute glomerulonephritis, which presented with gross hematuria but improved one week later. And one case with severe MR expired due to severe congestive heart failure. Eleven of the 14 survivors had regular follow-up at our clinic with an interval of 3 months to 38 months, and received parenteral benzathine penicillin for prophylaxis. During follow-up, the murmur in 4 cases with MR + MVP and 2 cases with MR + AR disappeared within 2 months. One of the three cases who had not received secondary prophylaxis had recurrence of rheumatic fever 3 years later after the initial diagnosis.