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ARF – Jones criteria high-risk — RACP Paediatrics MCQ

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HardCardiologyARF – Jones criteria high-riskRACP Paediatrics

A 7-year-old Aboriginal child presents with fever, migratory polyarthralgia, and subcutaneous nodules. Echocardiogram shows moderate mitral regurgitation with morphological changes consistent with acute carditis. ESR is 65 mm/hr. ASO titre is 400 IU/mL. Which Jones criteria classification does this fall under in a high-risk population?

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Correct answer: B — IM benzathine penicillin G

In high-risk populations (including Aboriginal and Torres Strait Islander Australians), the 2015 revised Jones criteria include monoarthritis and polyarthralgia as major criteria. This child has 2 major criteria (carditis + subcutaneous nodules) plus evidence of preceding streptococcal infection, meeting criteria for definite ARF. Immediate benzathine penicillin is essential for GAS eradication.

Reference: RHDAustralia – 2020 – Australian Guideline for ARF and RHD; AHA – 2015 – Revised Jones Criteria