Acute Rheumatic Fever (ARF): Jones Criteria, Carditis, and Prevention | Omicron Clinic<\/title>\n<meta name=\"description\" content=\"Le rhumatisme articulaire aigu est une complication inflammatoire du streptocoque b\u00eata-h\u00e9molytique du groupe A. Crit\u00e8res de Jones, cardite rhumatismale, p\u00e9nicilline et prophylaxie secondaire au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"rhumatisme articulaire aigu, RAA, RAA traitement, cardite rhumatismale, crit\u00e8res de Jones, streptocoque RAA, RAA prophylaxie, valvulopathie rhumatismale, p\u00e9nicilline RAA, RAA Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Cardiologie & Rhumatologie & P\u00e9diatrie<\/span>\n <h1>Rheumatic fever (RF)<\/h1>\n\n <div class=\"co-intro\">\n Le rhumatisme articulaire aigu (RAA) \u2014 d\u00e9sign\u00e9 fi\u00e8vre rhumatismale en anglais (<em>acute rheumatic fever<\/em>) \u2014 is a non-suppurative systemic inflammatory complication that occurs 2 to 4 weeks after pharyngitis caused by <em>Streptococcus pyogenes<\/em> (group A beta-hemolytic streptococcus - GAS), resulting from an abnormal immune response directed against certain streptococcal proteins (mainly the M protein) whose epitopes share a molecular homology with cardiac proteins (cardiac myosin + laminin + valvulin + tropomyosin), This triggers an autoimmune cross-reactivity that preferentially damages the heart (rheumatic carditis with endocardial, myocardial and pericardial involvement), joints (migratory polyarthritis), central nervous system (Sydenham's chorea) and skin (erythema marginalis + subcutaneous nodules). The most dreaded complication, with the most serious long-term consequences, is rheumatic carditis with valvular damage - mainly to the mitral valve (mitral insufficiency + mitral stenosis) and the aortic valve (aortic insufficiency) - which can evolve into severe, disabling chronic valvulopathy requiring heart valve surgery years or decades later. AAR is the leading cause of acquired heart disease in children and adolescents in developing countries, with an estimated 470,000 new cases and 230,000 deaths annually worldwide, mainly affecting children aged 5 to 15 living in conditions of overcrowding and precariousness that favor the transmission of streptococcal angina. In Canada and Quebec, AARS has become extremely rare thanks to early diagnosis and systematic antibiotic treatment of GAS pharyngitis, improved socio-economic conditions and reduced overcrowding - but it persists in certain northern aboriginal populations whose living conditions favor streptococcal transmission. The key to primary prevention is complete antibiotic treatment of all documented GAS pharyngitis + secondary prevention (prolonged antibiotic prophylaxis with monthly IM benzathine penicillin) in patients who have had AAR, to prevent recurrences that progressively worsen valvular lesions.\n <\/div>\n\n <h2>Crit\u00e8res de Jones r\u00e9vis\u00e9s (AHA 2015) \u2014 diagnostic du RAA<\/h2>\n <ul class=\"co-list\">\n <li><strong>Diagnostic = 2 crit\u00e8res majeurs OU 1 crit\u00e8re majeur + 2 crit\u00e8res mineurs + preuve d'une infection streptococcique r\u00e9cente (ASLO \u00e9lev\u00e9e + ou culture pharyng\u00e9e positive + ou TDR positif \u00e0 SGA)<\/strong><\/li>\n <li><strong>Crit\u00e8re majeur 1 \u2014 Cardite :<\/strong> Clinical carditis (new cardiac murmurs \u2014 mitral insufficiency ++ + aortic insufficiency + pericardial friction rub + signs of heart failure) OR subclinical carditis (echocardiographic abnormalities without clinical signs \u2014 valvular regurgitation on Doppler echo without audible murmur + valvular thickening) \u2192 subclinical carditis counts as a major criterion in high-prevalence populations<\/li>\n <li><strong>Crit\u00e8re majeur 2 \u2014 Polyarthrite (populations \u00e0 risque faible) \/ Monoarthrite ou polyarthralgie (populations \u00e0 risque \u00e9lev\u00e9) :<\/strong> Migratory arthritis (one joint after another, completely leaving the previous one) + large joints preferentially (knees + ankles + elbows + wrists) + very painful + spectacular response to NSAIDs (\u00abtherapeutic test\u00bb)<\/li>\n <li><strong>Crit\u00e8re majeur 3 \u2014 Chor\u00e9e de Sydenham :<\/strong> Involuntary, non-rhythmic, arrhythmic movements of the limbs and face, emotional lability, muscle weakness, shaky handwriting. Can occur up to 6 months after streptococcal pharyngitis (late onset). Its presence alone is sufficient for the diagnosis of rheumatic fever, even without proven streptococcal infection or other criteria.<\/li>\n <li><strong>Crit\u00e8re majeur 4 \u2014 \u00c9ryth\u00e8me margin\u00e9 :<\/strong> migrant annular rash + erythematous borders + pale center + non-pruritic + predominantly on trunk and limbs + fleeting and ephemeral + present in only 5\u201310 % of ARF<\/li>\n <li><strong>Crit\u00e8re majeur 5 \u2014 Nodules sous-cutan\u00e9s :<\/strong> firm + painless + mobile + nodules + on bony prominences (elbows + knees + wrists + ankles + spinous processes) + present in 5\u201310 % of RA + associated with severe carditis<\/li>\n <li><strong>Crit\u00e8res mineurs :<\/strong> fi\u00e8vre (> 38,5 \u00b0C dans les populations \u00e0 risque faible + > 38 \u00b0C dans les populations \u00e0 risque \u00e9lev\u00e9) + VS \u2265 60 mm\/h + ou CRP \u2265 30 mg\/L + allongement du PR \u00e0 l'ECG (bloc auriculo-ventriculaire du 1er degr\u00e9) + polyarthralgie (si l'arthrite n'est pas utilis\u00e9e comme crit\u00e8re majeur)<\/li>\n <\/ul>\n\n <h2>Cardite rhumatismale \u2014 la complication d\u00e9terminante<\/h2>\n <ul class=\"co-list\">\n <li><strong>Fr\u00e9quence et importance :<\/strong> pr\u00e9sente dans 50\u201360 % des premier \u00e9pisodes de RAA + d\u00e9termine le pronostic \u00e0 long terme + chaque r\u00e9cidive de RAA aggrave progressivement les l\u00e9sions valvulaires \u2192 obligation de la prophylaxie secondaire<\/li>\n <li><strong>Atteinte valvulaire pr\u00e9f\u00e9rentielle :<\/strong> mitral valve = most frequent and earliest affected \u2192 acute mitral regurgitation (systolic murmur at apex radiating to axilla) \u2192 can progress to mitral stenosis in 10 to 20 years due to progressive fibrosis and calcification \u2192 aortic valve (affected in 20\u201330 % in association with the mitral) \u2192 aortic regurgitation \u2192 aortic stenosis is rarer<\/li>\n <li><strong>\u00c9valuation \u00e9chocardiographique :<\/strong> Transthoracic echocardiogram = reference examination for detecting and quantifying valvular heart disease + typical abnormalities: thickening of the anterior mitral leaflet + mitral regurgitation + regurgitation jet towards the posterior wall of the left atrium (eccentric jet) + verrucous vegetations along the free edge of the valve leaflets<\/li>\n <li><strong>P\u00e9ricardite :<\/strong> pericardial friction rub + pleuritic chest pain + pericardial effusion on echo + generally resolves without sequelae with adequate anti-inflammatory treatment<\/li>\n <li><strong>Myocarditis<\/strong> disproportionate tachycardia + radiographic cardiomegaly + heart failure + elevated troponin + LV systolic dysfunction on echo \u2192 poorer prognosis<\/li>\n <\/ul>\n\n <h2>Paraclinical assessment<\/h2>\n <ul class=\"co-list\">\n <li><strong>ASLO (antistreptolysin O) :<\/strong> titre \u00e9lev\u00e9 (> 200 UI\/mL chez l'adulte + > 320 UI\/mL chez l'enfant) = preuve s\u00e9rologique d'une infection streptococcique r\u00e9cente + titre montant entre deux dosages \u00e0 2 semaines d'intervalle + l'ASLO peut \u00eatre n\u00e9gatif si l'\u00e9pisode de pharyngite remonte \u00e0 plus de 2 mois ou dans les formes avec chor\u00e9e (d\u00e9lai long) \u2192 anti-DNase B \u00e9galement utile car se positive plus tardivement et reste \u00e9lev\u00e9e plus longtemps<\/li>\n <li><strong>NFS + VS + CRP<\/strong> hyperleucocytose + syndrome inflammatoire biologique marqu\u00e9 + VS souvent > 60\u201380 mm\/h<\/li>\n <li><strong>Electrocardiogram<\/strong> PR prolongation (1st-degree AV block) = minor Jones criterion + sinus tachycardia<\/li>\n <li><strong>\u00c9chocardiographie transthoracique :<\/strong> to be performed on any patient with ARF to assess valvular involvement, search for subclinical carditis, even if the clinical examination is normal<\/li>\n <li><strong>Chest X-ray<\/strong> cardiomegaly if carditis + pleural effusion if pericarditis<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>La chor\u00e9e de Sydenham peut survenir jusqu'\u00e0 6 mois apr\u00e8s la pharyngite streptococcique initiale \u2014 longtemps apr\u00e8s que les autres manifestations du RAA se soient r\u00e9solues et que l'ASLO soit redevenue normale. Sa pr\u00e9sence isol\u00e9e (sans autres crit\u00e8res de Jones + sans ASLO \u00e9lev\u00e9e) suffit n\u00e9anmoins pour poser le diagnostic de RAA et initier la prophylaxie secondaire. Elle ne laisse g\u00e9n\u00e9ralement pas de s\u00e9quelles neurologiques permanentes mais peut r\u00e9cidiver. Traitement : acide valpro\u00efque + ou carbamaz\u00e9pine si mouvements invalidants + halte au halo p\u00e9ricardite p\u00e9rimyocardite si agitation.<\/span>\n <\/div>\n\n <h2>Treatment<\/h2>\n <ul class=\"co-list\">\n <li><strong>\u00c9radication streptococcique (traitement de l'\u00e9pisode aigu) :<\/strong> Oral penicillin V 500 mg \u00d7 2\/day \u00d7 10 days or amoxicillin 50 mg\/kg\/day \u00d7 10 days (child) or benzathine penicillin G 1.2 million IU IM single dose (if adherence is uncertain) + penicillin allergy: erythromycin or azithromycin<\/li>\n <li><strong>Anti-inflammatoires (arthrite + cardite l\u00e9g\u00e8re) :<\/strong> aspirin 80\u2013100 mg\/kg\/day (child) or 4\u20138 g\/day (adult) in 4\u20136 doses \u00d7 4\u20138 weeks \u2192 spectacular anti-inflammatory response in 24\u201348 h + resolution of polyarthritis \u2192 if no improvement in 48 h = reconsider diagnosis of ARF<\/li>\n <li><strong>Cortico\u00efdes (cardite mod\u00e9r\u00e9e \u00e0 s\u00e9v\u00e8re + insuffisance cardiaque) :<\/strong> prednisone 1\u20132 mg\/kg\/day (max 80 mg\/day) \u00d7 2\u20134 weeks \u2192 gradual tapering over 4\u20136 weeks + switch to tapering aspirin + do not improve long-term valvular prognosis (NAPAC + CORTIRAA studies) but reduce acute inflammation and improve heart failure<\/li>\n <li><strong>Traitement de l'insuffisance cardiaque si pr\u00e9sente :<\/strong> Diuretics + ACE inhibitors + digoxin if AF or systolic dysfunction + strict bed rest during the acute phase with carditis<\/li>\n <li><strong>Chor\u00e9e de Sydenham :<\/strong> valproic acid 15\u201320 mg\/kg\/day or carbamazepine if movements are very disabling + haloperidol if resistant + usual spontaneous resolution in 1 to 6 months<\/li>\n <\/ul>\n\n <h2>Prophylaxie secondaire \u2014 pr\u00e9vention des r\u00e9cidives<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Clinical situation<\/th>\n <th>Sch\u00e9ma prophylactique<\/th>\n <th>Dur\u00e9e minimale recommand\u00e9e<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>RAA sans cardite document\u00e9e<\/td>\n <td>P\u00e9nicilline benzathine G 1,2 million UI IM toutes les 4 semaines (ou p\u00e9nicilline V 250 mg \u00d7 2\/jour per os \u2014 moins fiable)<\/td>\n <td>5 ans apr\u00e8s le dernier \u00e9pisode ou jusqu'\u00e0 l'\u00e2ge de 21 ans (le d\u00e9lai le plus long)<\/td>\n <\/tr>\n <tr>\n <td>RAA avec cardite r\u00e9solue sans valvulopathie r\u00e9siduelle<\/td>\n <td>P\u00e9nicilline benzathine G 1,2 million UI IM toutes les 4 semaines<\/td>\n <td>10 ans ou jusqu'\u00e0 l'\u00e2ge de 21 ans (le d\u00e9lai le plus long)<\/td>\n <\/tr>\n <tr>\n <td>RAA avec valvulopathie r\u00e9siduelle (insuffisance mitrale + st\u00e9nose mitrale + insuffisance aortique)<\/td>\n <td>P\u00e9nicilline benzathine G 1,2 million UI IM toutes les 4 semaines + id\u00e9alement toutes les 3 semaines si risque \u00e9lev\u00e9 de r\u00e9exposition streptococcique<\/td>\n <td>10 ans ou jusqu'\u00e0 l'\u00e2ge de 40 ans (le d\u00e9lai le plus long) + certains experts recommandent la prophylaxie \u00e0 vie si valvulopathie significative<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Consultation m\u00e9dicale urgente recommand\u00e9e<\/div>\n <p>Consulter un m\u00e9decin ou un p\u00e9diatre rapidement si un enfant ou un adolescent de 5 \u00e0 15 ans pr\u00e9sente une polyarthrite migratrice douloureuse des grosses articulations + une fi\u00e8vre + dans les semaines suivant une angine \u2014 ce tableau \u00e9voque un RAA et impose un ECG + une \u00e9chocardiographie + un dosage d'ASLO dans les heures suivant la consultation. Toute suspicion de cardite (souffle cardiaque nouveau + tachycardie disproportionn\u00e9e + insuffisance cardiaque) n\u00e9cessite une hospitalisation pour \u00e9chocardiographie et traitement anti-inflammatoire imm\u00e9diat. Pour le bilan initial d'un RAA suspect\u00e9, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron diagnostiquent et traitent les pharyngites \u00e0 streptocoque pour pr\u00e9venir le RAA en primo-pr\u00e9vention, \u00e9valuent les patients suspects de RAA selon les crit\u00e8res de Jones (ASLO + ECG + \u00e9chocardiographie + NFS + CRP), initient le traitement antibiotique d'\u00e9radication streptococcique et le traitement anti-inflammatoire, et assurent la prophylaxie secondaire par p\u00e9nicilline benzathine IM mensuelle pour les patients ayant eu un RAA. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin, d'un p\u00e9diatre ou d'un cardiologue. Le rhumatisme articulaire aigu est une urgence m\u00e9dicale p\u00e9diatrique dont la prise en charge pr\u00e9coce conditionne le pronostic valvulaire \u00e0 long terme. La prophylaxie secondaire doit \u00eatre rigoureusement maintenue pendant toute la dur\u00e9e recommand\u00e9e pour \u00e9viter les r\u00e9cidives qui aggravent les l\u00e9sions valvulaires.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Rhumatisme articulaire aigu (RAA) : crit\u00e8res de Jones, cardite et pr\u00e9vention | Clinique Omicron Cardiologie & Rhumatologie & P\u00e9diatrie Rhumatisme articulaire aigu (RAA) Le rhumatisme articulaire aigu (RAA) \u2014 d\u00e9sign\u00e9 fi\u00e8vre rhumatismale en anglais (acute rheumatic fever) \u2014 est une complication inflammatoire syst\u00e9mique non suppurative, survenant 2 \u00e0 4 semaines apr\u00e8s une pharyngite \u00e0 Streptococcus… <a href=\"https:\/\/cliniqueomicron.ca\/en\/rhumatisme-articulaire-aigu\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Acute Rheumatic Fever (ARF): Jones Criteria, Carditis, and Prevention | Omicron Clinic<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Rhumatisme articulaire aigu (RAA) | Brossard | Clinique Omicron","_metasync_otto_description":"Rhumatisme articulaire aigu (RAA) Rhumatisme articulaire aigu (RAA) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropr...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Rhumatisme Articulaire Aigu | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Rhumatisme articulaire aigu (RAA) Rhumatisme articulaire aigu (RAA) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropr...","_metasync_otto_twitter_title":"Rhumatisme Articulaire Aigu | Clinique Omicron","_metasync_otto_twitter_description":"Rhumatisme articulaire aigu (RAA) Rhumatisme articulaire aigu (RAA) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropr...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Rhumatisme articulaire aigu (RAA) : crit\u00e8res de Jones, cardite et pr\u00e9vention | Clinique Omicron","_aioseo_description":"Le RAA est une complication auto-immune du streptocoque b\u00eata-h\u00e9molytique du groupe A. Crit\u00e8res de Jones 2015 cardite arthrite chor\u00e9e Sydenham ASLO, p\u00e9nicilline \u00e9radication, prophylaxie secondaire benzathine mensuelle au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-04T21:53:26+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-24931","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24931","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/comments?post=24931"}],"version-history":[{"count":4,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24931\/revisions"}],"predecessor-version":[{"id":31493,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24931\/revisions\/31493"}],"wp:attachment":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/media?parent=24931"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

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\n\t\t\t\t\t\n\n\n\n\nAcute Rheumatic Fever (ARF): Jones Criteria, Carditis, and Prevention | Omicron Clinic<\/title>\n<meta name=\"description\" content=\"Le rhumatisme articulaire aigu est une complication inflammatoire du streptocoque b\u00eata-h\u00e9molytique du groupe A. Crit\u00e8res de Jones, cardite rhumatismale, p\u00e9nicilline et prophylaxie secondaire au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"rhumatisme articulaire aigu, RAA, RAA traitement, cardite rhumatismale, crit\u00e8res de Jones, streptocoque RAA, RAA prophylaxie, valvulopathie rhumatismale, p\u00e9nicilline RAA, RAA Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Cardiologie & Rhumatologie & P\u00e9diatrie<\/span>\n <h1>Rheumatic fever (RF)<\/h1>\n\n <div class=\"co-intro\">\n Le rhumatisme articulaire aigu (RAA) \u2014 d\u00e9sign\u00e9 fi\u00e8vre rhumatismale en anglais (<em>acute rheumatic fever<\/em>) \u2014 is a non-suppurative systemic inflammatory complication that occurs 2 to 4 weeks after pharyngitis caused by <em>Streptococcus pyogenes<\/em> (group A beta-hemolytic streptococcus - GAS), resulting from an abnormal immune response directed against certain streptococcal proteins (mainly the M protein) whose epitopes share a molecular homology with cardiac proteins (cardiac myosin + laminin + valvulin + tropomyosin), This triggers an autoimmune cross-reactivity that preferentially damages the heart (rheumatic carditis with endocardial, myocardial and pericardial involvement), joints (migratory polyarthritis), central nervous system (Sydenham's chorea) and skin (erythema marginalis + subcutaneous nodules). The most dreaded complication, with the most serious long-term consequences, is rheumatic carditis with valvular damage - mainly to the mitral valve (mitral insufficiency + mitral stenosis) and the aortic valve (aortic insufficiency) - which can evolve into severe, disabling chronic valvulopathy requiring heart valve surgery years or decades later. AAR is the leading cause of acquired heart disease in children and adolescents in developing countries, with an estimated 470,000 new cases and 230,000 deaths annually worldwide, mainly affecting children aged 5 to 15 living in conditions of overcrowding and precariousness that favor the transmission of streptococcal angina. In Canada and Quebec, AARS has become extremely rare thanks to early diagnosis and systematic antibiotic treatment of GAS pharyngitis, improved socio-economic conditions and reduced overcrowding - but it persists in certain northern aboriginal populations whose living conditions favor streptococcal transmission. The key to primary prevention is complete antibiotic treatment of all documented GAS pharyngitis + secondary prevention (prolonged antibiotic prophylaxis with monthly IM benzathine penicillin) in patients who have had AAR, to prevent recurrences that progressively worsen valvular lesions.\n <\/div>\n\n <h2>Crit\u00e8res de Jones r\u00e9vis\u00e9s (AHA 2015) \u2014 diagnostic du RAA<\/h2>\n <ul class=\"co-list\">\n <li><strong>Diagnostic = 2 crit\u00e8res majeurs OU 1 crit\u00e8re majeur + 2 crit\u00e8res mineurs + preuve d'une infection streptococcique r\u00e9cente (ASLO \u00e9lev\u00e9e + ou culture pharyng\u00e9e positive + ou TDR positif \u00e0 SGA)<\/strong><\/li>\n <li><strong>Crit\u00e8re majeur 1 \u2014 Cardite :<\/strong> Clinical carditis (new cardiac murmurs \u2014 mitral insufficiency ++ + aortic insufficiency + pericardial friction rub + signs of heart failure) OR subclinical carditis (echocardiographic abnormalities without clinical signs \u2014 valvular regurgitation on Doppler echo without audible murmur + valvular thickening) \u2192 subclinical carditis counts as a major criterion in high-prevalence populations<\/li>\n <li><strong>Crit\u00e8re majeur 2 \u2014 Polyarthrite (populations \u00e0 risque faible) \/ Monoarthrite ou polyarthralgie (populations \u00e0 risque \u00e9lev\u00e9) :<\/strong> Migratory arthritis (one joint after another, completely leaving the previous one) + large joints preferentially (knees + ankles + elbows + wrists) + very painful + spectacular response to NSAIDs (\u00abtherapeutic test\u00bb)<\/li>\n <li><strong>Crit\u00e8re majeur 3 \u2014 Chor\u00e9e de Sydenham :<\/strong> Involuntary, non-rhythmic, arrhythmic movements of the limbs and face, emotional lability, muscle weakness, shaky handwriting. Can occur up to 6 months after streptococcal pharyngitis (late onset). Its presence alone is sufficient for the diagnosis of rheumatic fever, even without proven streptococcal infection or other criteria.<\/li>\n <li><strong>Crit\u00e8re majeur 4 \u2014 \u00c9ryth\u00e8me margin\u00e9 :<\/strong> migrant annular rash + erythematous borders + pale center + non-pruritic + predominantly on trunk and limbs + fleeting and ephemeral + present in only 5\u201310 % of ARF<\/li>\n <li><strong>Crit\u00e8re majeur 5 \u2014 Nodules sous-cutan\u00e9s :<\/strong> firm + painless + mobile + nodules + on bony prominences (elbows + knees + wrists + ankles + spinous processes) + present in 5\u201310 % of RA + associated with severe carditis<\/li>\n <li><strong>Crit\u00e8res mineurs :<\/strong> fi\u00e8vre (> 38,5 \u00b0C dans les populations \u00e0 risque faible + > 38 \u00b0C dans les populations \u00e0 risque \u00e9lev\u00e9) + VS \u2265 60 mm\/h + ou CRP \u2265 30 mg\/L + allongement du PR \u00e0 l'ECG (bloc auriculo-ventriculaire du 1er degr\u00e9) + polyarthralgie (si l'arthrite n'est pas utilis\u00e9e comme crit\u00e8re majeur)<\/li>\n <\/ul>\n\n <h2>Cardite rhumatismale \u2014 la complication d\u00e9terminante<\/h2>\n <ul class=\"co-list\">\n <li><strong>Fr\u00e9quence et importance :<\/strong> pr\u00e9sente dans 50\u201360 % des premier \u00e9pisodes de RAA + d\u00e9termine le pronostic \u00e0 long terme + chaque r\u00e9cidive de RAA aggrave progressivement les l\u00e9sions valvulaires \u2192 obligation de la prophylaxie secondaire<\/li>\n <li><strong>Atteinte valvulaire pr\u00e9f\u00e9rentielle :<\/strong> mitral valve = most frequent and earliest affected \u2192 acute mitral regurgitation (systolic murmur at apex radiating to axilla) \u2192 can progress to mitral stenosis in 10 to 20 years due to progressive fibrosis and calcification \u2192 aortic valve (affected in 20\u201330 % in association with the mitral) \u2192 aortic regurgitation \u2192 aortic stenosis is rarer<\/li>\n <li><strong>\u00c9valuation \u00e9chocardiographique :<\/strong> Transthoracic echocardiogram = reference examination for detecting and quantifying valvular heart disease + typical abnormalities: thickening of the anterior mitral leaflet + mitral regurgitation + regurgitation jet towards the posterior wall of the left atrium (eccentric jet) + verrucous vegetations along the free edge of the valve leaflets<\/li>\n <li><strong>P\u00e9ricardite :<\/strong> pericardial friction rub + pleuritic chest pain + pericardial effusion on echo + generally resolves without sequelae with adequate anti-inflammatory treatment<\/li>\n <li><strong>Myocarditis<\/strong> disproportionate tachycardia + radiographic cardiomegaly + heart failure + elevated troponin + LV systolic dysfunction on echo \u2192 poorer prognosis<\/li>\n <\/ul>\n\n <h2>Paraclinical assessment<\/h2>\n <ul class=\"co-list\">\n <li><strong>ASLO (antistreptolysin O) :<\/strong> titre \u00e9lev\u00e9 (> 200 UI\/mL chez l'adulte + > 320 UI\/mL chez l'enfant) = preuve s\u00e9rologique d'une infection streptococcique r\u00e9cente + titre montant entre deux dosages \u00e0 2 semaines d'intervalle + l'ASLO peut \u00eatre n\u00e9gatif si l'\u00e9pisode de pharyngite remonte \u00e0 plus de 2 mois ou dans les formes avec chor\u00e9e (d\u00e9lai long) \u2192 anti-DNase B \u00e9galement utile car se positive plus tardivement et reste \u00e9lev\u00e9e plus longtemps<\/li>\n <li><strong>NFS + VS + CRP<\/strong> hyperleucocytose + syndrome inflammatoire biologique marqu\u00e9 + VS souvent > 60\u201380 mm\/h<\/li>\n <li><strong>Electrocardiogram<\/strong> PR prolongation (1st-degree AV block) = minor Jones criterion + sinus tachycardia<\/li>\n <li><strong>\u00c9chocardiographie transthoracique :<\/strong> to be performed on any patient with ARF to assess valvular involvement, search for subclinical carditis, even if the clinical examination is normal<\/li>\n <li><strong>Chest X-ray<\/strong> cardiomegaly if carditis + pleural effusion if pericarditis<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>La chor\u00e9e de Sydenham peut survenir jusqu'\u00e0 6 mois apr\u00e8s la pharyngite streptococcique initiale \u2014 longtemps apr\u00e8s que les autres manifestations du RAA se soient r\u00e9solues et que l'ASLO soit redevenue normale. Sa pr\u00e9sence isol\u00e9e (sans autres crit\u00e8res de Jones + sans ASLO \u00e9lev\u00e9e) suffit n\u00e9anmoins pour poser le diagnostic de RAA et initier la prophylaxie secondaire. Elle ne laisse g\u00e9n\u00e9ralement pas de s\u00e9quelles neurologiques permanentes mais peut r\u00e9cidiver. Traitement : acide valpro\u00efque + ou carbamaz\u00e9pine si mouvements invalidants + halte au halo p\u00e9ricardite p\u00e9rimyocardite si agitation.<\/span>\n <\/div>\n\n <h2>Treatment<\/h2>\n <ul class=\"co-list\">\n <li><strong>\u00c9radication streptococcique (traitement de l'\u00e9pisode aigu) :<\/strong> Oral penicillin V 500 mg \u00d7 2\/day \u00d7 10 days or amoxicillin 50 mg\/kg\/day \u00d7 10 days (child) or benzathine penicillin G 1.2 million IU IM single dose (if adherence is uncertain) + penicillin allergy: erythromycin or azithromycin<\/li>\n <li><strong>Anti-inflammatoires (arthrite + cardite l\u00e9g\u00e8re) :<\/strong> aspirin 80\u2013100 mg\/kg\/day (child) or 4\u20138 g\/day (adult) in 4\u20136 doses \u00d7 4\u20138 weeks \u2192 spectacular anti-inflammatory response in 24\u201348 h + resolution of polyarthritis \u2192 if no improvement in 48 h = reconsider diagnosis of ARF<\/li>\n <li><strong>Cortico\u00efdes (cardite mod\u00e9r\u00e9e \u00e0 s\u00e9v\u00e8re + insuffisance cardiaque) :<\/strong> prednisone 1\u20132 mg\/kg\/day (max 80 mg\/day) \u00d7 2\u20134 weeks \u2192 gradual tapering over 4\u20136 weeks + switch to tapering aspirin + do not improve long-term valvular prognosis (NAPAC + CORTIRAA studies) but reduce acute inflammation and improve heart failure<\/li>\n <li><strong>Traitement de l'insuffisance cardiaque si pr\u00e9sente :<\/strong> Diuretics + ACE inhibitors + digoxin if AF or systolic dysfunction + strict bed rest during the acute phase with carditis<\/li>\n <li><strong>Chor\u00e9e de Sydenham :<\/strong> valproic acid 15\u201320 mg\/kg\/day or carbamazepine if movements are very disabling + haloperidol if resistant + usual spontaneous resolution in 1 to 6 months<\/li>\n <\/ul>\n\n <h2>Prophylaxie secondaire \u2014 pr\u00e9vention des r\u00e9cidives<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Clinical situation<\/th>\n <th>Sch\u00e9ma prophylactique<\/th>\n <th>Dur\u00e9e minimale recommand\u00e9e<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>RAA sans cardite document\u00e9e<\/td>\n <td>P\u00e9nicilline benzathine G 1,2 million UI IM toutes les 4 semaines (ou p\u00e9nicilline V 250 mg \u00d7 2\/jour per os \u2014 moins fiable)<\/td>\n <td>5 ans apr\u00e8s le dernier \u00e9pisode ou jusqu'\u00e0 l'\u00e2ge de 21 ans (le d\u00e9lai le plus long)<\/td>\n <\/tr>\n <tr>\n <td>RAA avec cardite r\u00e9solue sans valvulopathie r\u00e9siduelle<\/td>\n <td>P\u00e9nicilline benzathine G 1,2 million UI IM toutes les 4 semaines<\/td>\n <td>10 ans ou jusqu'\u00e0 l'\u00e2ge de 21 ans (le d\u00e9lai le plus long)<\/td>\n <\/tr>\n <tr>\n <td>RAA avec valvulopathie r\u00e9siduelle (insuffisance mitrale + st\u00e9nose mitrale + insuffisance aortique)<\/td>\n <td>P\u00e9nicilline benzathine G 1,2 million UI IM toutes les 4 semaines + id\u00e9alement toutes les 3 semaines si risque \u00e9lev\u00e9 de r\u00e9exposition streptococcique<\/td>\n <td>10 ans ou jusqu'\u00e0 l'\u00e2ge de 40 ans (le d\u00e9lai le plus long) + certains experts recommandent la prophylaxie \u00e0 vie si valvulopathie significative<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Consultation m\u00e9dicale urgente recommand\u00e9e<\/div>\n <p>Consulter un m\u00e9decin ou un p\u00e9diatre rapidement si un enfant ou un adolescent de 5 \u00e0 15 ans pr\u00e9sente une polyarthrite migratrice douloureuse des grosses articulations + une fi\u00e8vre + dans les semaines suivant une angine \u2014 ce tableau \u00e9voque un RAA et impose un ECG + une \u00e9chocardiographie + un dosage d'ASLO dans les heures suivant la consultation. Toute suspicion de cardite (souffle cardiaque nouveau + tachycardie disproportionn\u00e9e + insuffisance cardiaque) n\u00e9cessite une hospitalisation pour \u00e9chocardiographie et traitement anti-inflammatoire imm\u00e9diat. Pour le bilan initial d'un RAA suspect\u00e9, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron diagnostiquent et traitent les pharyngites \u00e0 streptocoque pour pr\u00e9venir le RAA en primo-pr\u00e9vention, \u00e9valuent les patients suspects de RAA selon les crit\u00e8res de Jones (ASLO + ECG + \u00e9chocardiographie + NFS + CRP), initient le traitement antibiotique d'\u00e9radication streptococcique et le traitement anti-inflammatoire, et assurent la prophylaxie secondaire par p\u00e9nicilline benzathine IM mensuelle pour les patients ayant eu un RAA. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin, d'un p\u00e9diatre ou d'un cardiologue. Le rhumatisme articulaire aigu est une urgence m\u00e9dicale p\u00e9diatrique dont la prise en charge pr\u00e9coce conditionne le pronostic valvulaire \u00e0 long terme. La prophylaxie secondaire doit \u00eatre rigoureusement maintenue pendant toute la dur\u00e9e recommand\u00e9e pour \u00e9viter les r\u00e9cidives qui aggravent les l\u00e9sions valvulaires.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Rhumatisme articulaire aigu (RAA) : crit\u00e8res de Jones, cardite et pr\u00e9vention | Clinique Omicron Cardiologie & Rhumatologie & P\u00e9diatrie Rhumatisme articulaire aigu (RAA) Le rhumatisme articulaire aigu (RAA) \u2014 d\u00e9sign\u00e9 fi\u00e8vre rhumatismale en anglais (acute rheumatic fever) \u2014 est une complication inflammatoire syst\u00e9mique non suppurative, survenant 2 \u00e0 4 semaines apr\u00e8s une pharyngite \u00e0 Streptococcus… <a href=\"https:\/\/cliniqueomicron.ca\/en\/rhumatisme-articulaire-aigu\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Acute Rheumatic Fever (ARF): Jones Criteria, Carditis, and Prevention | Omicron Clinic<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Rhumatisme articulaire aigu (RAA) | Brossard | Clinique Omicron","_metasync_otto_description":"Rhumatisme articulaire aigu (RAA) Rhumatisme articulaire aigu (RAA) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropr...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Rhumatisme Articulaire Aigu | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Rhumatisme articulaire aigu (RAA) Rhumatisme articulaire aigu (RAA) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropr...","_metasync_otto_twitter_title":"Rhumatisme Articulaire Aigu | Clinique Omicron","_metasync_otto_twitter_description":"Rhumatisme articulaire aigu (RAA) Rhumatisme articulaire aigu (RAA) est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropr...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Rhumatisme articulaire aigu (RAA) : crit\u00e8res de Jones, cardite et pr\u00e9vention | Clinique Omicron","_aioseo_description":"Le RAA est une complication auto-immune du streptocoque b\u00eata-h\u00e9molytique du groupe A. Crit\u00e8res de Jones 2015 cardite arthrite chor\u00e9e Sydenham ASLO, p\u00e9nicilline \u00e9radication, prophylaxie secondaire benzathine mensuelle au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-04T21:53:26+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-24931","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24931","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/comments?post=24931"}],"version-history":[{"count":4,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24931\/revisions"}],"predecessor-version":[{"id":31493,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24931\/revisions\/31493"}],"wp:attachment":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/media?parent=24931"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}