Given the different manifestations of this disease, there is no specific test which can definitively establish a diagnosis. In addition to a careful physical examination with attention to heart sounds, skin, joints, blood samples may be taken as part of the evaluation. These include tests for recurrent strep infection (ASO or antiDNAse B), complete blood counts and sedimentation rate (ESR). As part of the cardiac evaluation, an electrocardiogram may also be done.
In order to standardize the diagnosis of rheumatic fever, several minor and major criteria have been developed, which in conjunction with evidence of recent streptococcal infection allow a diagnosis of rheumatic fever.
The major diagnostic criteria include:
The minor criteria include fever, arthralgia, elevated erythrocyte sedimentation rate and other laboratory findings. Two major criteria, or one major and two minor criteria in the setting of evidence of a previous streptococcal infection (positive culture or rising antibody level -ASO or antiDNAse B) support the diagnosis of rheumatic fever.
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