Table 1 Updated Australian criteria for ARF diagnosis
From: Evaluation of an ARF diagnosis calculator: a survey and content analysis
High-risk groups† | Low-risk groups | |
|---|---|---|
Definite initial episode of ARF | 2 major manifestations + evidence of preceding Strep A infection, OR 1 major + 2 minor manifestations + evidence of preceding Strep A infection | |
Definite recurrent episode of ARF in a patient with a documented history of ARF or RHD | 2 major manifestations + evidence of preceding Strep A infection, OR 1 major + 2 minor manifestations + evidence of preceding Strep A infection, OR 3 minor manifestations + evidence of a preceding Strep A infection | |
Probable or possible ARF (first episode or recurrence) | A clinical presentation in which ARF is considered a likely diagnosis but falls short in meeting the criteria by either: • One major or one minor manifestation, OR • No evidence of preceding Strep A infection (streptococcal titres within normal limits or titres not measured) Such cases should be further categorised according to the level of confidence with which the diagnosis is made: • Probable ARF (previously termed ‘probable: highly suspected’) • Possible ARF (previously termed ‘probable: uncertain’) | |
Major manifestations | Carditis (including subclinical evidence of rheumatic valvulitis on echocardiogram) Polyarthritis or aseptic monoarthritis or polyarthralgia Sydenham chorea Erythema marginatum Subcutaneous nodules | Carditis (including subclinical evidence of rheumatic valvulitis on echocardiogram) Polyarthritis Sydenham chorea Erythema marginatum Subcutaneous nodules |
Minor Manifestations | Fever ≥ 38 °C Monoarthralgia ESR ≥ 30 mm/h or CRP ≥ 30 mg/L Prolonged P-R interval on ECG | Fever ≥ 38.5 °C Polyarthralgia or aseptic monoarthritis ESR ≥ 60 mm/h or CRP ≥ 30 mg/L Prolonged P-R interval on ECG |