Case:Rheumatic Fever with Caridits and Arthritis

A boy of 7 years with low socioeconomic background presented with intermittent fever migrating polyarthritis( Rt hip- Rt Knee – Rt ankle) and anorexia for 5 weeks with a history of sore throat week from the onset joint pain.

On examination, the patient was toxic, had active swelling and tenderness of the Rt Keen joint grossly and of the left foot mildly, had cardiomegaly,palpable p2, loud second sound and a pansystolic murmur in mitral area of grade III with radiation to the axilla. The patient has no basal creps, hepatomegaly or ankle oedema.







Clinically the patient was diagnosed as Rheumatic Fever with Carditis & Arthritis

His ESR was 80 mmhg, had neutrophilia, Raised ASO titre, Xray with cardiomegaly, ECG with tachycardia and Echo showing mitral incompetence.

Investigation confirms the clinical impression.

The patient was hospitalized, given short term Penicillin, prednisolone which will be followed by aspirin and is given long term penicillin as prophylaxis.

Patient is now improved and waiting for discharge.


Badrud Doza

Link:
Rheumatic Heart Disease- e-medicine
Diagnosis of Active Rheumatic Carditis -Circulation