Rheumatic fever is an inflammatory disease that occurs following a hemolytic streptococcal infection. The major symptoms of rheumatic fever are carditis, polyarthritis, subcutaneous nodules, erythema marginatum and chorea. Carditis is the most important prognostic factor, which can lead to permanent heart damage or fatal heart failure. Rheumatic fever is caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain. Due to the improvement of the general sanitary and medical conditions, rheumatic fever is seldom seen in developed countries.
We report herein on a case of rheumatic fever with a peritonsillar abscess and myocarditis. The patient was a 20 years old male, who complained at first of chest pain. He was diagnosed as having myocarditis, and the patient was admitted to intensive care unit (ICU). At the second day of admission, he complained of a sore throat and lockjaw. He was diagnosed as having a peritonsillar abscess and underwent incision and drainage. Group G hemolytic streptococcus was detected in the abscess and the serum concentration of anti-streptolysin O antibody (ASO) was very high. After 9 days of treatment with CLDM (clindamycin phosphate) and CTRX (ceftriaxone sodium hydrate), he completely recovered with no sequelae. Clinicians should be aware that rheumatic fever can develop secondary to streptococcal infections.
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