References:

  1. Global Infectious Diseases and Epidemiology Online Network: Infectious Diseases of the Philippines, 2013 eBook Edition, ISBN 978-1-61755-582-4, by Stephen Berger. Accessed here.

AgentBACTERIUM. Streptococcus pyogenes A facultative gram-positive coccus
ReservoirHuman
VectorNone
VehicleDroplet
Incubation Period1 to 5 weeks
Diagnostic TestsClinical diagnosis
Typical Adult TherapySupportive; salicylates
Typical Pediatric TherapyAs for adult
Clinical HintsMigratory arthritis, fever, carditis, chorea, subcutaneous nodules, erythema marginatum and leukocytosis; follows overt pharyngitis after 1 to 5 weeks in most cases; acute attack persists for approximately 3 months.
SynonymsFebbre reumatica

CDC Case Definition for Surveillance

A case requires evidence for preceding group A streptococcal infection (culture, serology) in addition to two major clinical criteria; or one major and two minor criteria, as follows:

  1. Major clinical criteria:
    • Carditis
    • Polyarthritis
    • Chorea
    • Subcutaneous nodules
    • Erythema marginatum
  2. Minor criteria:
    • Previous rheumatic fever or rheumatic heart disease
    • Arthralgia
    • Fever
    • Elevation of erythrocyte sedimentation rate (ESR)
    • Positive C-reactive protein
    • Leukocytosis
    • Prolongation of the PR interval on electrocardiogram.