Rheumatic fever in young adults.

During and immediately following World War II the opportunity presented itself to observe numerous cases of rheumatic fever in young adults. The present study was undertaken from patients admitted to the Brooke General Hospital over a period of one year. There were four hundred patients admitted for rheumatic fever during this time. Observation of each patient included the history, physical examination with special attention to the heart, complete blood count, examination of urine and stools, sedimentation rate, electrocardiogram, X-ray, and fluoroscopic examination. The diagnosis was based on these findings. Only if at least one major manifestation such as polyarthritis, carditis, chorea, old history of rheumatic fever, or nodules was present with several of the minor ones, such as fever, rash, epistaxis, leucocytosis, elevated sedimentation rate, and anmmia was the diagnosis made. Two hundred and two of these patients, all enlisted personnel of the Army, were diagnosed as having rheumatic fever, and were followed for several months, the average stay in the hospital being six months. Many have been observed for one year or more before discharge.