STUDY OF CLINICAL CHARACTERISTICS OF CHILDREN WITH ACUTE RHEUMATIC FEVER IN AL-ALWIYA PEDIATRICS HOSPITAL IN BAGHDAD
*Dr. Sahar Awad Hassan, Dr. Ahlam Mohammed Jawad Ibrahim and Dr. Shatha Jaafer Naser
ABSTRACT
Acute rheumatic fever (ARF) may have different clinical manifestations in different countries according to the genetic predisposition, prevalence of rheumatogenic strains, social and economic conditions. This study aimed to study was to determine the clinical characteristics of ARF in Al-Alwiya pediatrics hospital/Baghdad-Iraq and to improve the detection methods of the ARF cases. The current retrospective analysis included (60) clinical cases of inpatients aged (4-17) years and whose diagnosis with ARF was established according to Jones criteria and underwent treatment in Al-Alwiya pediatrics hospital during the period from 2009 to 2019. In this study, (63.3%) of patients showed fever and (65.0%) showed arthralgia which were the most common causes for admission to the medical care. The admission diagnosis was wrong in 24 (40.0%) children who underwent the treatment. The most frequent major Jones criteria of ARF were carditis (83.3%) and polyarthritis (55.0%). Chorea was significantly less common than carditis (P<0.001). The adequate treatment of the preceding streptococcal infection was administered in 17 children (51.5%). It can be concluded that the significant incidence of misdiagnoses in the ARF children during admission to the hospital, especially the interpretation of joint syndrome, indicates that physicians need an extra awareness. The lack of specific clinical signs of rheumatic carditis makes it a diagnostic challenge. The revised Jones criteria (2015) for the diagnosis of ARF can improve carditis detection. The adequate treatment of the preceding streptococcal infection may prevent ARF.
Keywords: Acute rheumatic fever, children, Jones criteria.
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