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May 1985, Vol 139, No. 5 >
Article | May 1985

Acute Rheumatic Fever FREE

S. K. SANYAL, FAAP, FACC
Am J Dis Child. 1985;139(5):441. doi:10.1001/archpedi.1985.02140070015009.
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Sir.—Majeed et al1 suggest that the current approach to long-term anti-streptococcal chemoprophylaxis for children with acute rheumatic fever (ARF) should be modified. According to these authors, children with rheumatic carditis should receive such prophylaxis probably indefinitely, whereas those children with arthritis alone should receive it for only five years. However, recent data from several countries, including their own country, raise serious concern about the applicability of these recommendations.

In a recent five-year prospective follow-up of ARF in children from north India,2 we observed 24 recurrences in 22 of the 85 patients. Twenty-two of these recurrences were directly related to omission of continuous anti

streptococcal chemoprophylaxis. Of the ten recurrences among children who had carditis during the initial attack, each recurrence manifested as carditis. Equally important, recurrences produced further cardiac damage in five children, including two children in whom heart murmur had disappeared totally two to three months

REFERENCES

1 +
Majeed HA, Shaltout A, Yousof AM:  Recurrences of acute rheumatic fever: A prospective study of 79 episodes . AJDC 1984;;138:341-345.
2 +
Sanyal SK, Berry AM, Duggal S, et al:  Sequelae of the initial attack of acute rheumatic fever in children from North India: A prospective five-year follow-up study . Circulation 1982;;65: 375-379.
3 +
Markowitz M, Gordis L:  Rheumatic fever , in Schaffer AJ (ed): Major Problems in Clinical Pediatrics . Philadelphia, WB Saunders Co, 1972;, vol 2, pp 63, 256.
4 +
Vardi P, Markiewicz W, Weiss Y, et al:  Clinical-echocardiographic correlations in acute rheumatic fever . Pediatrics 1983;;71:830-834.
5 +
Tolaymat A, Goudarzi T, Soler GP, et al:  Acute rheumatic fever in north Florida . South Med J 1984;;77:819-823.
6 +
Aron AM, Freeman J, Carter S:  The natural history of Sydenham's chorea: Review of the literature and long-term evaluation with emphasis on cardiac sequelae . Am J Med 1965;;38:83-95.
7 +
Kuttner AG, Mayer FE:  Carditis during second attack of rheumatic fever: Its incidence in patients without clinical evidence of cardiac involvement within initial rheumatic episode . N Engl J Med 1963;;268:1259-1261.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Majeed HA, Shaltout A, Yousof AM:  Recurrences of acute rheumatic fever: A prospective study of 79 episodes . AJDC 1984;;138:341-345.
2 +
Sanyal SK, Berry AM, Duggal S, et al:  Sequelae of the initial attack of acute rheumatic fever in children from North India: A prospective five-year follow-up study . Circulation 1982;;65: 375-379.
3 +
Markowitz M, Gordis L:  Rheumatic fever , in Schaffer AJ (ed): Major Problems in Clinical Pediatrics . Philadelphia, WB Saunders Co, 1972;, vol 2, pp 63, 256.
4 +
Vardi P, Markiewicz W, Weiss Y, et al:  Clinical-echocardiographic correlations in acute rheumatic fever . Pediatrics 1983;;71:830-834.
5 +
Tolaymat A, Goudarzi T, Soler GP, et al:  Acute rheumatic fever in north Florida . South Med J 1984;;77:819-823.
6 +
Aron AM, Freeman J, Carter S:  The natural history of Sydenham's chorea: Review of the literature and long-term evaluation with emphasis on cardiac sequelae . Am J Med 1965;;38:83-95.
7 +
Kuttner AG, Mayer FE:  Carditis during second attack of rheumatic fever: Its incidence in patients without clinical evidence of cardiac involvement within initial rheumatic episode . N Engl J Med 1963;;268:1259-1261.

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