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Abstract
Acute rheumatic fever (ARF) is an autoimmune, multi-system response secondary to molecular
mimicry following Lancefield group A streptococcus (GAS) pharyngitis; it is now most
commonly found in the pediatric populations of developing nations. The major source
of morbidity and mortality of ARF stems from rheumatic heart disease (RHD), although
the cardinal symptoms of the disease also include polyarthritis, Sydenham's chorea,
subcutaneous nodules, and erythema marginatum. Therapy is aimed towards treating the
initial GAS infection, using anti-inflammatory medications for acute symptoms and
surgery to correct RHD. Secondary prevention is crucial, given the high risk of recurrence,
and includes long-term antibiotic prophylaxis. However, vaccination towards GAS may
soon be on the horizon, which may assist in both decreasing the risk of initial infection
in naïve patients and helping to lower the risk of recurrence.