Present Status of Diagnostic Tests for Rheumatic Fever

THE diagnosis of rheumatic fever offers no difficulties in those cases which present the classic clinical picture. Due to the great variability of the disease, however, only a minority of the total cases fall into this category, and it is frequently necessary to look to the laboratory for assistance in establishing the diagnosis. In view of this fact, it is unfortunate that none of the many tests employed provides an unequivocal answer concerning the occurrence of the disease. At the present time, no laboratory test is avail-able which is comparable in its significance to the serologic tests for syphilis or to the specific bacteriologic and serologic procedures used in a variety of other infectious diseases. The various tests that have been recommended as aids in the diagnosis of rheumatic fever, since they lack specificity and are inconclusive by themselves, can be used only as a source of additional information to be considered along with clinical data in weighing the evi-dence for and against the diagnosis. It is important, therefore, to evaluate accurately the tests employed and to be aware of their limitations.