BMJ  2003;327:631-632 (20 September), doi:10.1136/bmj.327.7416.631

Editorial

Treating acute rheumatic fever

So many years, and yet we do not know if steroids should be used

The first 150 words of the full text of this article appear below.

Rheumatic fever is a delayed complication of pharyngeal infection with group haemolytic streptococci. Susceptible individuals develop a diffuse inflammatory disease of the heart, joints, brain, blood vessels, and subcutaneous tissue. Carditis is the most serious manifestation of the disease. It may culminate in chronic valvular disease and can lead to heart failure and ultimately death. The incidence of acute rheumatic fever has declined in industrialised countries since the 1950s. However, a resurgence of the disease has been noted, and new epidemics have been reported in the United States.¹ Acute rheumatic fever continues to be an important cause of acquired heart disease in developing countries where it is an endemic disease.² Open heart surgery may be needed to repair or replace heart valves in patients with severely damaged valves, the cost of which is exorbitant and a drain on the meagre health resources of poor countries.

Because of substantial evidence pointing . . . [Full text of this article]

CH Baragwanath Hospital, PO Box 2588, Northcliff, 2115, Johannesburg, South Africa (amcilliers@icon.co.za)

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Rapid Responses:

Read all Rapid Responses

Why not adding Bryonia ?

harold j. bueno de mesquita
bmj.com, 19 Sep 2003 [Full text]

How long do we need to treat with steroids ?

Oommen John
bmj.com, 19 Sep 2003 [Full text]

rheumatic fever as of now.

manan vasenwala
bmj.com, 19 Sep 2003 [Full text]

Need for Prevention of Acute Rheumatic Fever

Anil Pandit
bmj.com, 20 Sep 2003 [Full text]

Frustruations galore!

Vijayashankara.c nanjegowda
bmj.com, 21 Sep 2003 [Full text]

Treating recurrent rheumatic fever

Friedrich Flachsbart
bmj.com, 24 Sep 2003 [Full text]

Steroids and Rheumatic Fever

Joseph F Cosgrove
bmj.com, 30 Sep 2003 [Full text]

High doses of intravenous methylprednisolone is not better than oral corticosteroid to treat severe rheumatic carditis.

Edmundo J Camara, et al.
bmj.com, 31 Oct 2003 [Full text]

Why not Absolute Bed Rest For Acute Rheumatic Fever?

Munir E Nassar, M.D., Ph.D.
bmj.com, 11 Jan 2004 [Full text]

Acute Rheumatic Fever and Antiphospholipid Antibody Syndrome!

Friedrich Flachsbart
bmj.com, 2 Feb 2004 [Full text]