Key Predictors of Rheumatic Fever in Patients with Sore Throat

Pavankumar Kamat


October 26, 2021


  • Risk factors for developing rheumatic fever (RF) in patients with sore throat (ST) in endemic areas include a positive group A streptococcal (GAS) swab, history of previous RF, and a cardiac murmur.

Why this matters

  • There are no recent data on primary care populations with ST in low- and middle-income countries to identify which individuals are at risk of developing RF or rheumatic heart disease to inform guidelines on antibiotic prescriptions.

Study design

  • UK researchers performed a meta-analysis of 7 studies (3 randomised controlled trials; 4 observational studies), including 6890 participants, identified through a search across electronic databases.

  • Funding: None.

Key results

  • Risk factors associated with the development of RF following ST were (OR; 95% CI):

    • Positive GAS swab (1.74; 1.13-2.69; P=.01);

    • previous RF history (13.22; 4.86-35.93; P<.00001); and

    • cardiac murmur (3.55; 1.81-6.94; P=.0002).


  • Heterogeneity among studies.


Kulik E, Stuart B, Willcox M. Predictors of rheumatic fever in sore throat patients: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg. 2021 Oct 12 [Epub ahead of print]. doi: 10.1093/trstmh/trab156. PMID: 34636404  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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