All patients with suspected acute rheumatic fever (first episode or recurrence) should be discussed immediately with a paediatrician or adult physician expert in the diagnosis and management of ARF, admitted to hospitalised as soon as possible after the onset of symptoms, and the steps initiated to confirm the diagnosis.
While in hospital, the patient should be registered in centralised and local ARF/RHD registers.
Occasionally, when the diagnosis has already been confirmed and the patient is not unwell (e.g. mild recurrent chorea in a child with no other symptoms or signs), outpatient management may be appropriate, but only after consultation with a specialist.
