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viagra going generic 2012 Jump to: page content, site navigation, site search clinical evidence patient leaflets help choose your formulary: edit formulary settings × english search show conditions searchbest practice rheumatic fever highlights summary overview basics definition epidemiology aetiology pathophysiology classification prevention primary screening secondary diagnosis history & examination tests differential step-by-step criteria guidelines case history treatment details step-by-step guidelines evidence follow up recommendations complications prognosis resources references images online resources patient leaflets credits email print feedback share add to portfolio bookmark add notes notes cancel notes cancel summary acute rheumatic fever continues to cause a large burden of mortality and morbidity in developing countries. It is less common in developed countries but continues to be seen in indigenous communities and during outbreaks. cheap generic viagra generic viagra online viagra without a doctor prescription buy cheap viagra generic viagra online cheap viagra online viagra for sale buy generic viagra viagra without a doctor prescription It is caused by an autoimmune process following infection with group a streptococci. No single test can diagnose acute rheumatic fever. Diagnosis is clinical and relies on the jones criteria. The 5 major manifestations of acute rheumatic fever are carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules, of which the most common are carditis and polyarthritis. While all other manifestations of acute rheumatic fever resolve without sequelae, carditis can lead to chronic rheumatic heart disease. No treatment has been shown to alter the progression of acute rheumatic fever to chronic rheumatic heart disease. Secondary prophylaxis can improve the prognosis of established rheumatic valvular disease. Other related conditions assessment of fever of unknown origin assessment of fever of unknown origin in children mitral regurgitation aortic regurgitation mitral stenosis acute pharyngitis septic arthritis juvenile idiopathic arthritis reactive arthritis lyme disease sickle cell anaemia infective endocarditis overview of leukaemia gout calcium pyrophosphate deposition mitral valve prolapse overview of congenital heart disease hypertrophic cardiomyopathy myocarditis pericarditis systemic lupus erythematosus wilson's disease gastritis encephalitis tic disorders cerebral palsy huntington's disease overview of brain tumours.