Abstract
Objective: Acute rheumatic fever remains a significant cause of morbidity and mortality, particularly in developing countries. According to the Modified Jones Criteria updated by the American Heart Association in 2015, populations with an annual incidence of fewer than 2 new cases per 100,000 individuals are considered low-risk. A nationwide multicenter study conducted in Türkiye reported an annual incidence of 8.8 per 100,000, classifying the country as being within the moderate–to–high–risk category. In this study, we aimed to evaluate the clinical, demographic, and echocardiographic characteristics of patients diagnosed with acute rheumatic fever at a secondary healthcare center.
Material and Methods: The clinical and demographic data of patients diagnosed with acute rheumatic fever at Denizli State Hospital between March 2015 and December 2024 were retrospectively evaluated. Patient records were accessed through the hospital’s electronic database.
Results: A total of 60 patients were diagnosed with acute rheumatic fever during the study period. The most common presenting complaint was joint pain. Carditis and joint involvement (91.6% and 92.8%, respectively) were the most frequently observed major manifestations, while Sydenham chorea was diagnosed in 30% of the patients. According to the most recently modified criteria, the frequencies of polyarthritis, monoarthritis, and polyarthralgia as major manifestations were similar (30.1%, 28.6%, and 33.3%, respectively). Treatment-related complications included hepatotoxicity in four patients, and epistaxis, peptic ulcer, steroid-induced myopathy, esophageal candidiasis, and hyponatremia in one patient each.
Conclusion: Acute rheumatic fever remains a commonly encountered disease in Türkiye. With the recent updates to the Jones Criteria, the proportion of missed acute rheumatic fever cases in moderate-to-high–risk populations is expected to decline substantially. The high frequency and clinical significance of both the disease itself and its treatment-related complications underscore the importance of effective streptococcal eradication and early diagnosis.
Keywords: Acute rheumatic fever, arthritis, carditis, child, Sydenham chorea
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