Rheumatic fever in an urban community

Area of Science:

• Pediatrics
• Cardiology
• Rheumatology

Background:

• Acute rheumatic fever (ARF) is a significant cause of acquired heart disease in children globally.
• Rheumatic heart disease (RHD) remains a major public health concern, especially in developing regions.
• Understanding the clinical spectrum and outcomes of ARF is crucial for effective management.

Purpose of the Study:

• To describe the clinical presentation, management, and outcomes of pediatric patients with acute rheumatic fever.
• To assess the prevalence of cardiac involvement and the development of rheumatic heart disease.
• To evaluate the compliance with prophylactic treatment in children diagnosed with ARF.

Main Methods:

• Retrospective analysis of pediatric patients admitted with ARF.
• Data collection on patient demographics, clinical manifestations, and treatment adherence.
• Assessment of cardiac involvement, including echocardiographic findings and need for surgical intervention.

Main Results:

• Forty-six children with ARF were admitted over a 3.7-year period.
• Carditis was the most common manifestation (26 patients), followed by arthritis (22 patients).
• Thirty-five patients developed rheumatic heart disease, predominantly mitral regurgitation; 3 died and 3 required emergency valve replacement.

Conclusions:

• Acute rheumatic fever in children carries a high risk of developing rheumatic heart disease, primarily mitral regurgitation.
• Effective long-term prophylaxis is essential but challenging to achieve, as indicated by low compliance rates.
• Prompt diagnosis and management are critical to prevent severe cardiac complications and mortality in pediatric ARF patients.