The changing picture of rheumatic fever.

Rheumatic fever has decreased in frequency and severity, but the disease has not been eradicated in this country, especially in low socioeconomic populations. Carditis is less common, and changes in the frequency of other rheumatic manifestations such as chorea has made the clinical diagnosis more difficult. Streptococcal antibody tests are still the most useful laboratory aid, but care must be taken against overinterpretation. The search for the answer to the pathogenesis puzzle continues. Until the nature of the disease is better understood, it is unlikely that rheumatic fever will be eradicated. In the meantime, however, the incidence of the disease can be reduced further by improved medical care for deprived populations.