Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Rheumatic fever (acute rheumatic fever or ARF) is an autoimmune disease that may occur after a
group A streptococcal throat infection that causes inflammatory lesions in
connective tissue, especially that of the heart, joints, blood vessels, and
subcutaneous tissue. The disease has been described since the 1500s, but the
association between a throat infection and rheumatic fever symptom development
was not described until the 1880s. It was associated with scarlet fever (rash
caused by streptococcal exotoxins) in the 1900s. Prior to the broad availability
of penicillin, rheumatic fever was a leading cause of death in children and one
of the leading causes of acquired heart disease in adults. The disease has many
symptoms and can affect different parts of the body, including the heart,
joints, skin, and brain. There is no simple diagnostic test for rheumatic
fever, so the American Heart Association's modified Jones criteria (first
published in 1944 and listed below) are used to assist the physician in making
the proper diagnosis.
What are the Jones criteria?
Jones criteria are guidelines decided on by the American Heart Association to
help doctors clinically diagnose rheumatic fever. Two major criteria or one
major and two minor plus a history of a streptococcal throat infection are
required to make the diagnosis of rheumatic fever.