An Unusual Presentation of Acute Rheumatic Fever

Derya Arslan,Bulent Oran,Osman Guvenc,Derya Cimen

doi:10.15197/ejgm.01366

Derya Arslan, Bulent Oran + Show 2 more

Open Access

https://doi.org/10.15197/ejgm.01366

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Abstract

Acute rheumatic fever (ARF) is a multisystem disease caused by an immunological response to group A streptococcus infection. Its sequel rheumatic heart disease continue to cause a large burden of morbidity and mortality in developing countries. Early detection of ARF is paramount to the prevention of rheumatic heart disease. We report a case of ARF with presenting epistaxis. The variety of clinical manifestations, which may be the presenting signs and symptoms of ARF, are not included in the updated-revised Jones criteria. Therefore, a careful examination and awareness of the disease can play an important role in identifying ARF.

Highlights

Acute rheumatic fever is a public health concern due to carditis and heart damage, which may be aggravated by late diagnosis and poor penicilin prophylaxis adherence
Our unusual presentation was the epistaxis on admission of the patient
In approximate 50% of cases of Acute rheumatic fever (ARF), cardiac involvement will be evident severe decompensated cardiac failure is rare

Summary

INTRODUCTION

Acute rheumatic fever is a public health concern due to carditis and heart damage, which may be aggravated by late diagnosis and poor penicilin prophylaxis adherence. It is a diffuse inflammatory process involving the connective tissues that appears in approximately 0.3 percent of untreated patients suffering infections of the upper respiratory tract by the group A beta haemolytic streptococcus. The valid diagnostic criteria for ARF are clinically and laboratory based. The diagnosis of ARF is clinically based using the revised Jones criteria [1,3,6]. The evidence of preceding group A streptococcal pharyngitis was added to the list of minor It was suggested that exclusion of clinical syndromes of non-streptococcal origin would further increase the accuracy of the criteria [6]

Acute rheumatic fever and epistaxis

Findings

DISCUSSION