NCBISkiptomaincontentSkiptonavigationResourcesHowToAboutNCBIAccesskeysMyNCBISignintoNCBISignOutJournalListBMJv.333(7579);2006Dec2PMC1676147BMJ.2006Dec2;333(7579):1153–1156.doi: 10.1136/bmj.39031.420637.BEPMCID:PMC1676147PMID:17138996RheumaticfeveranditsmanagementAntoinetteMCilliers,consultantAntoinetteMCilliers1DivisionofPaediatricCardiology,CHBaragwanathHospital,POBox2588,Northcliff,2115,Johannesburg,SouthAfricaFindarticlesbyAntoinetteMCilliersAuthorinformationArticlenotesCopyrightandLicenseinformationDisclaimer1DivisionofPaediatricCardiology,CHBaragwanathHospital,POBox2588,Northcliff,2115,Johannesburg,SouthAfricaEmail:[email protected]©BMJPublishingGroupLtd2006ThisarticlehasbeencitedbyotherarticlesinPMC.AssociatedDataSupplementaryMaterials[extra:References]bmj_333_7579_1153__index.html(614bytes)GUID: 2AE9B98B-3D58-4638-8539-3E61088591F1bmj_333_7579_1153__1.pdf(250K)GUID: 9D4CF12D-F541-4666-BDC9-E70A9DB62D19Thediagnosisofacuterheumaticfeverisaclinicalchallengeanddependsonthepossibilityofthediseasebeingborneinmind.AlthoughthecompleteeradicationofrheumaticfeverfromtheWesternworldhasnotbeenachieved,thediseaseisoftenforgotteninthedifferentialdiagnosisofapatientwithfeverandpolyarthralgiaorarthritis.Rheumaticfeverremainsanimportantacquiredcardiacdiseaseinlowandmiddleincomecountriesandamongpoorlyresourcedcommunitiesinhighincomecountries.Rheumaticheartdiseaseplacesaheavyeconomicburdenonthehealthcaresysteminlowandmiddleincomecountriesbecauseofthecostsofmedicaltreatmentandheartvalvesurgeryandalsobecauseitisadiseaseofyoungadults,whoarethemosteconomicallyactivegroupofanypopulation.Managementiscomplexandinvolvesdifferentlevelsofcare.Theonlynewadvancesinthemanagementofacuterheumaticfevertodateareinthedevelopmentofvaccines.SummarypointsRheumaticheartdiseaseisamajorcauseofmorbidityandmortalityinlowandmiddleincomecountriesandamongunderprivilegedcommunitiesinhighincomecountriesPrimarypreventionofacuterheumaticfeverrequiresadequateantibiotictreatmentofst