Acute rheumatic fever

Case contributed by Dr David Preston

Presentation

This Indigenous Australian was admitted to a rural hospital with high fevers and shortness of breath. Originally treated as having pneumonia.

Patient Data

Age: 16 years
Gender: Male
X-ray

Plain chest film shows bilateral increased interstitial markings. Heart shadow is obscured although appears enlarged. Left sided pleural effusion noted.

After referral to a tertiary hospital, the patient was intubated and required inotropes. An echo was obtained which showed torrential regurgitation of the mitral and aortic valves. A diagnosis of rheumatic heart disease was made. Treatment included high dose aspirin.

X-ray

The patient is intubated and ventilated. Cardiomegaly is now clearly seen. 

The patient went to theatre for mitral and aortic valve replacement. 

X-ray

Post thoracotomy. Valvular protheses noted. ETT, NGT, CVC and intercostal catheter present. 

Case Discussion

Recovery was swift and transfer to the ward then back home soon followed.

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Case information

rID: 23053
Published: 18th May 2013
Last edited: 19th Nov 2019
Inclusion in quiz mode: Included

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