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Acute rheumatic fever in adults
1Department of Medicine, University of Cape Town.
South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|September 15, 1990
Summary
Acute rheumatic fever in adults commonly presents with arthritis but notably showed significant cardiac involvement in this series. This highlights the potential impact of local factors on disease severity and presentation.
Area of Science:
- Rheumatology
- Cardiology
- Infectious Diseases
Background:
- Acute rheumatic fever (ARF) is a significant cause of acquired heart disease globally.
- While commonly affecting children, ARF in adults can present differently and may be underdiagnosed.
- Understanding ARF epidemiology in diverse populations is crucial for effective management.
Purpose of the Study:
- To describe the clinical features and outcomes of adult patients with acute rheumatic fever.
- To investigate the prevalence of cardiac involvement in adult ARF cases.
- To identify potential local factors influencing ARF presentation and morbidity.
Main Methods:
- Retrospective review of adult patients diagnosed with ARF.
- Data collection included demographics, clinical manifestations, diagnostic criteria, and treatment outcomes.
- Analysis focused on the frequency of major ARF criteria and cardiac complications.
Main Results:
- Thirty-one adult cases of ARF were identified over a 10-year period.
- Arthritis was the most frequent major criterion, consistent with other studies.
- Cardiac involvement was a prominent feature, occurring more frequently than expected.
- Two deaths and four valve replacements were directly attributed to ARF complications.
Conclusions:
- Adult ARF at this institution presented with significant cardiac morbidity.
- Local factors may influence the clinical expression and severity of ARF.
- Physicians should maintain a high index of suspicion for ARF in adults with unexplained carditis or valvular disease.