19th June 2024

Diagnosis

Diagnosis is based on the revised Jones criteria. This entails evidence of recent streptococcal infection as well as 2 major criteria, or 1 major and 2 minor.

Major criteria
Evidence of recent streptococcal infection (1 of the following):
Positive throat culture for group A beta-haemolytic streptococci
Positive rapid streptococcal antigen test
Elevated or rising antistreptococcal antibody titre – Either Anti-Streptolysin O (ASO) or Anti-Deoxyribonuclease B (ADB)
Evidence of Major criteria (1 of the following):
Arthritis – usually migratory polyarthritis involving large joints
Carditis or Valvulitis (i.e. pancarditis), this can be clinical or subclinical
CNS involvement (e.g. Sydenham’s chorea)
Subcutaneous nodules
Erythema marginatum
Minor Criteria
Arthralgia
Fever
Elevated acute phase reactants (ESR or CRP)
Prolonged PR interval on ECG

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