Rheumatic fever : Dr Jones would smile if we get rid of the “ supportive criteria ”

Dr. Duckett Jones, the famed American physician, from Good Samaritan hospital, Boston would be a proud man in heaven, to find his criteria still being celebrated all over the globe. He will also be pleased to know his home country USA  is painted green on the world RHD map due to his untiring efforts that began in 1944. Of course, what the rest of the world has done in the last century has left us wanting (including the WHO).   Global RHD map. Note the red and brown shading in south Asia and Africa. It is obvious, RHD is more about economics, equality, and poverty, rather than aggression from an otherwise innocuous microbe called streptococci which is omnipresent all over the world with equal concentration. How to diagnose  Acute rheumatic fever (ARF)? Simple. Apply jones’ criteria. Funnily, I found it can be a most difficult exercise to do, especially If we realize ARF can defy all the three components it carries. ARF  need not be acute, need not have rheumatic symptoms & curiously they need not have fever as well. Did you note this? The entire disease process can be subclinical in 50 % of children. Intelligent patients must realize, how scientifically quixotic conditions we, the doctors are expected to practice medicine. There is one more ongoing confusion in many of us. Is Jone’s criteria meant for diagnosing the first episode of ARF, or second, or any subsequent episodes?  In the strict sense, it can be applied only for the first episode. But...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: rheumatic heart disease acute rheumatic fever aso titer chronic rheumatic fever dr duckket jones jones criteria primary vs secondory prevention rtpcr for rheumatic fever supportive criteria for acute rheumatic fever essential Source Type: blogs