when do you say the patient has rheumatic fever based on jones criteria
Rheumatic fever Modified Jones criteria were first published in 1944 by T. Duckett Jones, MD.[25] They have been periodically revised by the American Heart Association in collaboration with other groups.[26] According to revised Jones criteria, the diagnosis of rheumatic fever can be made when two of the major criteria, or one major criterion plus two minor criteria, are present along with evidence of streptococcal infection: elevated or rising antistreptolysin O titre or DNAase.[8] Exceptions are chorea and indolent carditis, each of which by itself can indicate rheumatic fever.[27][28][29] An April 2013 review article in the Indian Journal of Medical Research stated that echocardiographic and Doppler (E & D) studies, despite some reservations about their utility, have identified a massive burden of rheumatic heart disease, which suggests the inadequacy of the 1992 Jones' criteria. E & D studies have identified subclinical carditis in patients with rheumatic fever, as well as in follow-ups of rheumatic heart disease patients who initially presented as having isolated cases of Sydenham's chorea.[30] Signs of a preceding streptococcal infection include: recent scarlet fever, raised antistreptolysin O or other streptococcal antibody titre, or positive throat culture.[31]