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Back| Main Manifestations | Minor Manifestations | Evidence of Streptococcal Infection |
|---|---|---|
| Carditis | Fever | Recent history of scarlet fever |
| Wandering Polyarthritis | Joint Pain | Positive throat culture |
| Chorea | History of rheumatic fever | Positive rapid streptococcal antigen test |
| Erythema Marginatum | Increased ESR, positive CRP | Increased anti-streptolysin O titers |
| Subcutaneous Nodules | Prolonged P-R interval | |
| Note: If arthritis is the main manifestation, joint pain is not counted as a minor manifestation; if carditis is the main manifestation, prolonged P-R interval is not counted as a minor manifestation. | ||
Explanation
Due to the different pathways activated by various drugs, a diagnosis can be made with 2 major manifestations or 1 major manifestation + 2 minor manifestations, provided that there is evidence of Group A streptococcal infection.
Because the clinical manifestations of rheumatic fever are complex, atypical and mild cases have increased in recent years. It is rare to have 2 major manifestations, and evidence of streptococcal infection can sometimes be difficult to determine, so rigid adherence to these criteria can lead to diagnostic errors. Therefore, only by comprehensively analyzing all clinical data and, if necessary, long-term follow-up observations can the diagnostic rate be improved.
