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Adult-Onset Acute Rheumatic Fever: Possible Resurgence in Southern Taiwan

Wang, Chrong-Reen MD, PhD*; Liu, Ching-Chaun MD; Li, Yi-Heng MD, PhD; Liu, Ming-Fei MD*

JCR: Journal of Clinical Rheumatology: June 2005 - Volume 11 - Issue 3 - p 146-149
doi: 10.1097/01.rhu.0000164821.73024.86
Original Article

Background: By the late 1980s, acute rheumatic fever (ARF) had become a rare disease in Taiwan. The low prevalence rate in this area is attributed to a better economic status, which has led to improved public health and adequate medical services.

Objectives: The increasing number of patients with adult-onset ARF in the United States described in the literature prompted us to evaluate the cases diagnosed in our medical center.

Methods: A retrospective chart review was performed for patients with arthritis from July 1988 to October 2004. To be included, patients had to meet revised Jones criteria.

Results: Three adult patients with ARF have been diagnosed since June 2001, with no childhood ARF being diagnosed. All cases presented with migratory polyarthritis, whereas 1 had erythema marginatum and transient carditis. These patients responded well to treatment with antibiotics and nonsteroidal antiinflammatory drugs.

Conclusions: Clinicians must provide careful assessment and treatment to patients presenting with acute pharyngitis. A possible resurgence of ARF can be eradicated by primary prevention of streptococcal pharyngitis.

Poststreptococcal migratory arthritis and features meeting Jones criteria can still be seen in developed countries. This remains important to recognize.

From the *Section of Rheumatology, Department of Internal Medicine, the †Section of Infectious Disease, Department of Pediatrics, and the ‡Section of Cardiology, Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Reprints: Chrong-Reen Wang, MD, PhD, Assistant Professor, Section of Rheumatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University, No.1 University Road, Tainan, Taiwan. E-mail:

© 2005 Lippincott Williams & Wilkins, Inc.