Acute rheumatic fever: Clinical aspects and insights into pathogenesis and prevention

Acute rheumatic fever (ARF) is an inflammatory disease of childhood that occurs following untreated Group A streptococcal pharyngeal infections. Although it is well established that group A streptococcus is the sole etiologic agent of ARF, the pathogenesis and immune mechanisms are still not completely understood. We review the clinical manifestations, diagnostic, and therapeutic aspects of ARF. We also review recent advances in the understanding of disease pathogenesis, host susceptibility, and vaccine strategies to prevent group A streptococcal infection.