Diagnosis and occurrence of rheumatic fever in Denmark 1980 and 1983. An analysis based on hospital records of the fulfillment of the revised Jones criteria
Hoffmann, S.; Henrichsen, J.; Schmidt, K.
Ugeskrift for Laeger 149(34): 2277-2282
1987
ISSN/ISBN: 0041-5782 PMID: 3451454 Document Number: 295593
The hospital records for 141 patients discharged during 1980 or 1983 with a diagnosis of acute rheumatic fever (ASRF) were evaluated as regards fulfillment of the revised Jones-criteria. The criteria were fulfilled for 47 patients, 23 of whom, however, exhibited features rendering it unlikely that they had had ARF. In 86 cases, the hospital discharge diagnosis was at odds with the revised Jones-criteria. Eight patients did not formally fulfill the criteria, but were nevertheless possible cases of ARF. Thus, a total of 32 patients possibly had had ARF. Among these, 22 had polyarthritis, fever, elevated acute-phase reactants, and serological evidence of preceding streptococcal infection; these patients may very well have had simple post-infectious arthritis. Two out of three patients suspected of having Sydenham's chorea minor did not appear to have had a rheumatic disease. Fifteen (11%) of the 141 cases had been reported to The National Board of Health. The current annual incidence of ARF in Denmark is, at most, 0.3 per 100,000 inhabitants. It is proposed to consider continuous antibiotic prophylaxis only in patients with definite signs of rheumatic carditis.