{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T15:10:50Z","timestamp":1781104250035,"version":"3.54.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T00:00:00Z","timestamp":1647302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Rheumatol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Our aims were to clinically and epidemiologically characterize rheumatic fever (RF) in the current era in Israel. Although there has been a steady decline in the incidence of RF in the western world, evidence of disease resurgence in developed countries continues to be published. The paucity of recent epidemiological data prompted our study.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Medical files were retrospectively reviewed for all children with RF in our tertiary pediatric university-affiliated hospital from 1993 to 2017. Main outcome measures were patients and disease related characteristics, incidence trends, risk factors, disease course, relapse rates and secondary prophylaxis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The cohort included 307 children. Sixty-four percent presented with arthritis, interestingly including hips and small joints of hands and feet at presentation, 52% presented with carditis. Severe carditis developed in 31 patients (19.5%), of whom 21 (13.2% of all carditis patients) acquired heart failure, 5 required intensive care monitoring, with one recent death. The percentage of patients with acute carditis of the overall RF patients remained relatively stable.\u00a0Thirty-two patients (10% of patients with RF) relapsed, including 11 with a cardiac relapse (3.6% of all cardiac patients). The recurrence rate of RF continued to rise up to 9 years from the initial episode. One of 147 patients (&lt;\u20090.7%) with a non-cardiac initial presentation had carditis at relapse.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>RF and rheumatic heart disease remain an important cause of morbidity and mortality including developed countries, with relapse rate continuing after 9 years of prophylaxis. Presentation of small joints as well as hips, although uncommon, should not exclude the diagnosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12969-022-00678-7","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T07:03:01Z","timestamp":1647327781000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Rheumatic fever in a developed country \u2013 is it still relevant? A retrospective, 25\u2009years follow-up"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8655-9264","authenticated-orcid":false,"given":"Rotem","family":"Tal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Hamad Saied","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razi","family":"Zidani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoel","family":"Levinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Straussberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Amir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Amarilyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liora","family":"Harel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,15]]},"reference":[{"key":"678_CR1","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/S0140-6736(05)66874-2","volume":"366","author":"JR Carapetis","year":"2005","unstructured":"Carapetis JR, McDonald M, Wilson NJ. Acute rheumatic fever. Lancet. 2005;366:155\u201368.","journal-title":"Lancet"},{"key":"678_CR2","doi-asserted-by":"publisher","first-page":"1806","DOI":"10.1161\/CIR.0000000000000205","volume":"131","author":"MH Gewitz","year":"2015","unstructured":"Gewitz MH, Baltimore RS, Tani LY, et al. American Heart Association Committee on rheumatic fever, endocarditis, and Kawasaki disease of the council on cardiovascular disease in the young. Revision of the Jones criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation. 2015;131:1806\u201318.","journal-title":"Circulation"},{"key":"678_CR3","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1016\/S1473-3099(05)70267-X","volume":"5","author":"JR Carapetis","year":"2005","unstructured":"Carapetis JR, Steer AC, Mulholland EK, et al. The global burden of group a streptococcal diseases. 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The resurgence of rheumatic fever in a developed country area: the role of echocardiography. Rheumatology. 2011;50:396\u2013400.","journal-title":"Rheumatology"},{"key":"678_CR7","doi-asserted-by":"publisher","first-page":"135","DOI":"10.3934\/publichealth.2018.2.135","volume":"5","author":"V Munteanu","year":"2018","unstructured":"Munteanu V, Petaccia A, Contecaru N, et al. Pediatric acute rheumatic fever in developed countries: neglected or negligible disease? Results from an observational study in Lombardy (Italy). AIMS Public Health. 2018;5:135\u201343.","journal-title":"AIMS Public Health"},{"key":"678_CR8","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1161\/CIRCULATIONAHA.113.001477","volume":"128","author":"JG Lawrence","year":"2013","unstructured":"Lawrence JG, Carapetis JR, Griffiths K, et al. Acute rheumatic fever and rheumatic heart disease: incidence and progression in the Northern Territory of Australia, 1997 to 2010. 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RMC-17-0253).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20"}}