Rheumatic fever in children.

Rheumatic fever (RF) and rheumatic heart disease (RHD) are major public health problems in developing countries. A prospective study carried out in a large general hospital showed that carditis was the predominant feature in first attack and also the recurrence of RF but that recurrence was associated with more severe manifestations. Echocardiography picked up cases of subclinical carditis. Presence of congestive cardiac failure in association with carditis always led to chronic RHD. Recurrence occurred only when patient defaulted penicillin prophylaxis. The overall recurrence rate was 0.026 per patient.