Acute Rheumatic Fever Differential Diagnoses

Updated: Nov 04, 2018
  • Author: Robert J Meador, Jr, MD; Chief Editor: Herbert S Diamond, MD  more...
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DDx

Diagnostic Considerations

Other problems to be considered include the following:

  • Bacterial endocarditis

  • Still disease - Systemic-onset juvenile rheumatoid arthritis or adult Still disease

  • Vasculitis

Poststreptococcal reactive arthritis

Barash et al performed a retrospective study to compare clinical and laboratory features of acute rheumatic fever (ARF) versus poststreptococcal reactive arthritis to determine whether the two diseases are separate clinical manifestations of the same disease or are in fact different diseases altogether. Based on a review of 68 patients with ARF and 159 patients with poststreptococcal reactive arthritis, the authors concluded that at least four factors differed significantly enough to show that the two diseases are distinct: erythrocyte sedimentation rate (ESR), C-reactive protein levels, duration of joint symptoms after initiation of anti-inflammatory treatment, and relapse of joint symptoms after treatment cessation. Using the differentiating factors, they were able to determine the correct diagnosis in more than 80% of cases. [18]

Differential Diagnoses