الفهرس 
Introduction and aim of the work
Changing pattern of acute rheumatic feverOnly 14 pages are availabe for public view
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Abstract
The present study including 197 children their ages ranged from 3-16 years. They were referred to the outpatient clinic of MUCH. The cases were referred mainly by general practitioners children with the provisional diagnosis of the initial attack of ARF or RHD. The aim of the present work was to characterize the changing pattern of rheumatic fever presentation in children with definite diagnosis. Also to identify and analyze the sources of errors in the diagnosis among the referred cases with provisional diagnosis of RF or RHD. Moreover to highlight the utility of Color Doppler echocardiography in identification of subclinical carditis in patients with definite or probable diagnosis ofRF.All children included in the study were classified into 2 groups as follow: group 1: children with provisional diagnosis of ARF with total number of 160(81 male, 79 female) divided into 3 groups according to the final diagnosis; group 1 : patients with definite diagnosis of rheumatic fever included 119 patients (74.4 %)(58 male, 61 female), group 2: patients with probable diagnosis of rheumatic fever included 14 patients (8.8 %)(6 male, 8 female) and group 3: patients misdiagnosed as rheumatic fever included 27 patients (16.8 %)( 15 male, 12 female). 2. group II: children with provisional diagnosis of RHD with total number of 36 (20 male, 16 female) divided into 2 groups according to the final diagnosis as follow: group l: patients with definite diagnosis of RHO; included 11 patients (30.5%) (6 male, 5 female) and group 2: patients misdiagnosed as RHD included 25 patients (69.5 %) (14 male, 11 female).