title: Adult-onset acute rheumatic fever: possible resurgence in southern Taiwan.
abstract: BACKGROUND
  By the late 1980s, acute rheumatic fever (ARF) had become a rare disease in Taiwan. The low prevalence rate in this area is attributed to a better economic status, which has led to improved public health and adequate medical services.
  
  
  OBJECTIVE
  The increasing number of patients with adult-onset ARF in the United States described in the literature prompted us to evaluate the cases diagnosed in our medical center.
  
  
  METHODS
  A retrospective chart review was performed for patients with arthritis from July 1988 to October 2004. To be included, patients had to meet revised Jones criteria.
  
  
  RESULTS
  Three adult patients with ARF have been diagnosed since June 2001, with no childhood ARF being diagnosed. All cases presented with migratory polyarthritis, whereas 1 had erythema marginatum and transient carditis. These patients responded well to treatment with antibiotics and nonsteroidal antiinflammatory drugs.
  
  
  CONCLUSIONS
  Clinicians must provide careful assessment and treatment to patients presenting with acute pharyngitis. A possible resurgence of ARF can be eradicated by primary prevention of streptococcal pharyngitis.
authors.affiliation: Section of Rheumatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. wangcr@mail.ncku.edu.tw
authors.forename: Chrong-Reen
authors.initials: CR
authors.lastname: Wang
authors.forename: Ching-Chaun
authors.initials: CC
authors.lastname: Liu
authors.forename: Yi-Heng
authors.initials: YH
authors.lastname: Li
authors.forename: Ming-Fei
authors.initials: MF
authors.lastname: Liu
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000989:Antistreptolysin / Q000097:blood; D001168:Arthritis / Q000188:drug therapy / Q000382:microbiology; D001799:Blood Sedimentation; D002512:Cephalothin / Q000627:therapeutic use; D004890:Erythema / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D009205:Myocarditis / Q000188:drug therapy / Q000382:microbiology; D010400:Penicillin G / Q000627:therapeutic use; D010612:Pharyngitis / Q000188:drug therapy / Q000382:microbiology; D012189:Retrospective Studies; D012213:Rheumatic Fever / Q000175:diagnosis* / Q000188:drug therapy; D013624:Taiwan
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000989:Antistreptolysin; D010400:Penicillin G; D002512:Cephalothin