Acute rheumatic fever in Konya, Turkey

Background: Patients with acute rheumatic fever (ARF), who were admitted to Pediatric Cardiology Unit of Selcuk University Faculty of Medicine from Ju ly 1993 to 1998, were studied retrospectively to verify the clinical profil e of the disease and to compare the results with those from other countries . Methods: All patients were examined by one: of the two pediatric cardiologi sts in our study group. Every patient had a chest X-ray, electrocardiogram and an echocardiographic investigation. Throat culture, antistreptolysin O test, C-reactive protein and sedimentation rates were investigated for each patient. Results: During the study period, 274 cases with ARF were identified among patients admitted to the present institution. There were 8032 visits during the study period, giving an occurrence rate of 3.4%. Arthritis was the mos t common major manifestation (81.4%). It was followed by carditis (60.9%) a nd chorea (17.9%). Subcutaneous nodules (0.7%) and erythema marginatum (0.4 %) were both seen in patients with carditis, The mitral valve was the most commonly affected valve (95.8%), followed by the aortic valve (40.1%). Two patients died and regurgitation disappeared in 21% of patients with mitral regurgitation. Fifteen patients (14%) with isolated arthritis and pure chor ea had mitral regurgitation demonstrated by echocardiographic investigation but without any significant murmur. Conclusion: The present study indicates that ARF is still a significant pro blem in Konya and that recurrences can be prevented by administering a 3-we ek benzathine penicillin G regimen.