Acute rheumatic fever: 15-year single-center experience of a middle-income country in Latin America

Diego A. Lozano-Espinosa, Pediatric Cardiology Unit, HOMI, Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia
Kelly C. Márquez-Herrera, Pediatric Infectology Unit, Clínica Infantil Santa María del Lago, Bogotá, Colombia
Víctor M. Huertas-Quiñonez, Division of Pediatric Cardiology, Fundación Cardioinfantil-La Cardio; Pediatric Department, School of Medicine, Universidad Nacional de Colombia; Bogotá, Colombia
Roy Sanguino-Lobo, Pediatric Cardiology Unit, HOMI, Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia
Adriana Díaz-Maldonado, Pediatric Rheumatology Unit, HOMI, Fundación Hospital Pediátrico La Misericordia; Pediatric Rheumatology Unit, Instituto Roosevelt. Bogotá, Colombia

Objective: Acute rheumatic fever (ARF) is the leading cause of acquired heart disease in children and young adults in developing countries. The objective is to describe the clinical and epidemiological presentation of patients under 18 years of age with ARF in a pediatric hospital in Colombia over a period of 15 years (2006-2020), emphasizing cardiac involvement. Methods: Case series study of children with rheumatic fever for 15 years (2006 to 2020). Results: Seventy patients under the age of 18 with criteria for acute rheumatic fever were evaluated. Mean age was 10 years. Chorea was the most frequent manifestation (n = 51, 72.8%) followed by carditis (n = 31, 44.2%). Cases of ARF were proportionally more frequent from 2015 (43/70, 61.4%), as did the frequency of carditis (19/31, 61.2%) and subclinical carditis (7/11, 63.6%). Eight percent had a PR prolongation. Conclusions: The incidence in this study is high (moderate-risk). Chorea was the most frequent initial manifestation, which reflects the late diagnosis. The case frequency of acute rheumatic fever, especially for carditis and subclinical carditis, increased considerably beginning in 2015. Echocardiographic is trascendent because 35.4% of cases with carditis were subclinical.

Keywords: Fiebre reumática aguda. Carditis. Carditis subclínica. Corea. Artritis.