Acute rheumatic fever in north Florida

Because of the declining incidence and severity of acute rheumatic fever reported in the United States and Europe, we reviewed our clinical experiences with 128 cases of acute rheumatic fever. No decline in the rate of admissions for patients with rheumatic fever was found in our hospital. The most common major manifestation of rheumatic fever in our patients was carditis, followed by arthritis. Chorea, erythema marginatum, and subcutaneous nodules were rare. Carditis was severe in 26% of the patients, moderate in 27%, and mild in 47%. A high percentage of our patients had residual cardiac lesions, and the mortality was higher than what has been reported in the rest of the country. We conclude that primary prevention of rheumatic fever in areas like ours should be continued.