Problems in the Clinical Application of Revised Jones Diagnostic Criteria for Rheumatic Fever

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The revised Jones diagnostic criteria, 1965, for rheumatic fever were applied to the 143 cases which had been diagnosed as rheumatic fever by modified Jones criteria, 1956.Sixty-five per cent of the total cases were diagnosed as rheumatic fever by new as well as old criteria. In 10 per cent of the total cases diagnosis of rheumatic fever was established after the application of the exception rules.Twenty-five per cent of the total cases, 36 cases, were excluded by new criteria, in which 21 cases had rheumatic carditis. These excluded cardiac cases were divided into 2 groups; typical carditis with low ASO level and carditis with only one minor manifestation and elevated ASO level.The revised Jones criteria are considered to be insatisfactory in the definite diagnosis for the following types of rheumatic carditis; rheumatic carditis with an insidious onset, carditis seen after 2 months or more from the onset of the disease, carditis of a recurrent attack and typical carditis with a low ASO level.
International Heart Journal刊行会の論文