LAUSR

Acute rheumatic fever (ARF) is an autoimmune reaction following infection with Group A Streptococcus pyogenes (GAS). 1 It most commonly affects children aged 5 – 15 years and is characterised by in fl ammatory manifestations of carditis, arthritis, chorea and erythema marginatum. 1,2 A diagnosis of ARF is made using the Modi fi ed Jones Criteria, and these criteria are categorised into major and minor manifestations of the disease. 3 Major criteria consist of carditis, arthritis, chorea, erythema marginatum and subcutaneous nodules, and minor criteria consist of fever, arthralgia, elevated acute phase reactants, prolonged PR interval on ECG, and previous rheumatic fever or rheumatic heart disease (RHD). 3,4 For a diagnosis of de fi nite ARF, either two major criteria, or one major and two minor criteria are required, (cid:1) evidence of preceding GAS infection. Severe or recurrent ARF episodes can lead to the chronic valvulopathic changes of RHD, which continues to be a major contributor to paediatric and adult cardiac disease, especially in Indigenous Australians. 5