A 10-year-old presents 3 weeks after a sore throat with fever, painful migratory polyarthritis, and a new high-pitched blowing pansystolic murmur at the apex. Jones criteria 2015 revision: which combination correctly identifies the required number of criteria for high-risk population diagnosis?

• A One major OR two minor criteria with evidence of prior streptococcal infection (low-risk population only)
• B Two major OR one major plus two minor criteria (without streptococcal evidence required)
• C Three major criteria without streptococcal evidence in high-risk populations
• D Two major OR one major plus two minor criteria with evidence of prior streptococcal infection ✓

Explanation

The 2015 AHA revised Jones criteria for rheumatic fever diagnosis require (in both low-risk and high-risk populations) either two major criteria OR one major plus two minor criteria, PLUS evidence of preceding group A streptococcal infection (elevated ASOT/Anti-DNase B, positive throat culture, or positive rapid strep antigen test). In high-risk populations (where ARF incidence >2/100,000/year), the criteria are identical but monoarthritis/polyarthralgia may count as a major/minor criterion respectively, reflecting clinician judgment. This child has carditis (new murmur = major) and arthritis (major) — satisfying two major criteria.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.