DRG Category: 315

Mean LOS: 4.5 days

Description MEDICAL: Other Circulatory System Diagnosis with CC

DRG Category: 546

Mean LOS: 5.3 days

Description MEDICAL: Connective Tissue Disorders with CC

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Acute rheumatic fever is an autoimmune disorder that follows an upper respiratory infection with group A beta-hemolytic streptococci. Rheumatic fever affects the heart, central nervous system, skin, and musculoskeletal system. In addition to an initial insult, recurrences are common. Only 3% of people who have a pharyngeal streptococcal infection actually develop rheumatic fever.

Acute rheumatic fever is most destructive to the heart. Rheumatic heart disease (RHD) occurs in up to 50% of patients with acute rheumatic fever and may affect any of the layers of the heart during the acute phase. Endocarditis leads to leaflet swelling of the valves, leaflet erosion, and deposits of blood and fibrin on the valves; these deposits are called vegetation. Myocarditis causes cellular swelling, damage to collagen, and formation of fibrosis and scarring. Pericarditis can occur as well, which can lead to pericardial effusion. In addition to valvular disease, acute rheumatic fever can lead to severe carditis and life-threatening heart failure. Complications lead to a 20% death rate within the first 10 years after the initial illness.