Rheumatic fever with uncommon clinical findings: a case report.

• Autor(a) principal: Campos, Alexandre Azevedo
• Data de Publicação: 2007
• Outros Autores: Pereira, Luciana Vandesteen, Campos Fernandes, Regina Célia de Souza
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Científica da Faculdade de Medicina de Campos
• Texto Completo: https://www.fmc.br/ojs/index.php/RCFMC/article/view/160
• topic: Artrite; Febre reumática; Criança; Diagnóstico; Arthritis; Rheumatic fever; Children; Diagnosis

Introduction: Multisystem involvement (that is, arthritis, carditis, and chorea) is commonly recognized in acute rheumatic fever. However, renal and pleural involvement in this disease has received only scant attention. Objective: To describe a case of rheumatic fever with uncommon clinical findings as occurrence of renal involvement, pleurisy in the absence of cardiac failure, short interval between pharyngitis and arthritis and the involvement of small joints of the hand. Methods: Review of medical record. Case report: An 11-year-old girl was admitted with pain in legs, fever and was receiving amoxicillin for streptococcal pharyngitis since five days ago. She had macroscopic hematuria; migratory polyarthritis involving small joints of the hand; carditis; and small pleural effusion. Manifestations of this girl satisfied the Jones criteria for diagnosis of RF: 2 major and all minor. A streptococcal infection was evidenced by ASLO and she responded to aspirin and prednisone. Conclusion: The diagnosis of rheumatic fever is not based in laboratory evaluations, but in clinical manifestations. The occurrence of atypical findings represents an additional difficulty in diagnosis. It is important to perform a detailed clinical evaluation, without which quality of life may be greatly affected and with elevation in public health costs.