Which of the following is the most common clinical presentation of acute rheumatic fever (ARF)?

Which of the following is the most common clinical presentation of acute rheumatic fever (ARF)?

1.Carditis
2.Chorea
3.Erythema marginatum
4.Polyarthiritis
5.Subcutaneous nodules

sol:

Acute rheumatic fever (ARF) is almost universally due to group A streptococcal disease at the present time, though virtually all streptococcal disease may be capable of precipitating rheumatic fever. Although skin infections may be associated with rheumatic fever, far and away the most common presentation is with preceding pharyngitis. There is a latent period of approximately 3 weeks from an episode of sore throat to presentation of ARF. The most common manifestations are fever and polyarthritis, with polyarthritis being present in 60–75% of cases. Carditis may also be present, though somewhat less frequently in 50–60% of cases. Chorea and indolent carditis may have a subacute presentation. Chorea is present in 2–30% of affected individuals, while erythema marginatum and subcutaneous nodules are rare. Sixty percent of patients with ARF progress to rheumatic heart disease, with the endocardium, pericardium, and myocardium all potentially involved. All patients with ARF should receive antibiotics sufficient to treat the precipitating group A streptococcal infection.