Acute Rheumatic Fever

Acute Rheumatic Fever (ARF) is an autoimmune response to untreated or inadequately treated Group A Streptococcus infections, particularly streptococcal pharyngitis. Primarily affecting children and adolescents, ARF can manifest with a range of symptoms, including arthritis, carditis, skin rash, subcutaneous nodules, and Sydenham's chorea. The inflammatory response in ARF is directed against various tissues, particularly the heart, joints, and skin. Carditis is a significant component of ARF, potentially leading to rheumatic heart disease (RHD), a chronic condition characterized by valvular damage. The mitral valve is commonly affected, resulting in mitral stenosis or regurgitation. Recurrent episodes of ARF can exacerbate valvular lesions, contributing to the progression of RHD. Diagnosis of ARF involves the Jones criteria, which consider clinical manifestations, laboratory findings, and evidence of a preceding streptococcal infection. Treatment includes antibiotics to eliminate the streptococcal infection and anti-inflammatory medications such as aspirin or corticosteroids to manage symptoms and reduce inflammation. Prevention of ARF recurrence and subsequent RHD involves long-term antibiotic prophylaxis. This prophylaxis is crucial in individuals with a history of ARF to prevent further streptococcal infections and subsequent autoimmune responses. Public health efforts also focus on early detection and prompt treatment of streptococcal infections to minimize the risk of ARF development.