Evidence of recent streptococcal infection
This is satisfied if there is:
- a history of recent scarlet fever or,
- a positive streptococcal growth from throat swab, or,
- there is an increase in antistreptolysin O titre
Note that a carbohydrate antibody persists in patients with valvular rheumatic heart disease. This may help to discriminate non-rheumatic valvular heart disease from rheumatic heart disease.
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