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April 30, 1973

Section 23.—Rheumatic Fever

JAMA. 1973;224(Suppl_5):736-739. doi:10.1001/jama.1973.03220190076026

Rheumatic fever is an inflammatory disease which occurs as a sequel to infection with group A streptococci.1 Although its name emphasizes involvement of the joints, rheumatic fever owes its importance to involvement of the heart, which may occur in one third to one half of the cases. Involvement of the heart can be fatal during the acute stage of the disease; more frequently, it leads to chronic scarring and deformity of the heart valves.

Origin.  Antecedent group A streptococcal infection can be demonstrated in the acute stage of rheumatic fever, both clinically and serologically, by titers of antibodies to streptococcal antigens. Furthermore, the disease can be prevented by therapy or prophylaxis of streptococcal infections.

Epidemiology.  Rheumatic fever may occur at any age, but it is extremely rare in infancy and is observed most commonly between the ages of 5 and 15 years when streptococcal infections are most frequent. Similarly,