children s health issues
Rheumatic Fever
Diagnosis of Rheumatic Fever
Established clinical criteria Throat cultures Blood tests Electrocardiography and often echocardiography A doctor bases the diagnosis of rheumatic fever on the a combination of symptoms and test results called the Modified Jones Criteria (see How Do Doctors Diagnose Rheumatic Fever? ). Although there is no laboratory test that specifically diagnoses rheumatic fever, doctors do blood tests to look for high levels of antibodies to streptococci. Doctors also look for streptococci by swabbing the child's throat and sending the swab to a laboratory for examination. Other blood tests, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein, help doctors determine whether inflammation is present in the body and how widespread it is. The ESR and C-reactive protein are increased when inflammation is present. Doctors do Electrocardiography (ECG—recording the heart's electrical activity) to look for abnormal heart rhythms caused by heart inflammation. Doctors may do If doctors are not sure whether a red, swollen joint is caused by a joint infection, rather than rheumatic fever, they may use a needle to remove fluid from the joint ( Joint aspiration (arthrocentesis) ) and do tests on the fluid. Doctors diagnose children with rheumatic fever if they have had a streptococcal infection and 2 major criteriaor1 major criterion and 2 minor criteria: Major criteriafor rheumatic fever: Inflammation of the heart (carditis) Jerky, uncontrollable movements (Sydenham chorea) Rash (erythema marginatum) Redness, pain, and swelling (arthritis) in several joints Bumps (nodules) under the skin Minor criteriafor rheumatic fever: Pain in several joints (without redness or swelling) Elevated erythrocyte sedimentation rate or C-reactive protein Fever Abnormal heart rhythms 