engleski

Acute Rheumatic Fever: Unusual Presentation With Abdominal Pain and Acute Meningoencephalitis in a 10-Year-Old Boy

Acute rheumatic fever (ARF) is a nonsuppurative, immune-mediated sequela of infection with the group A Streptococcus (GAS), presenting as a multisystem disease mostly in children 5 to 15 years of age. Patients with ARF present with different range of clinical features, the major of which are carditis, polyarthritis, Sydenham’s chorea, erythema marginatum, and subcutaneous nodules. Laboratory findings include elevated inflammatory markers and elevated/rising anti- streptolysin O (ASO) or anti- deoxyribonuclease (anti-DNAse) B antibodies (1) Sometimes, however, patients present with relatively nonspecific and unusual symptoms, such as rheumatic pneumonia, epistaxis, serositis, abdominal pain, involvement of the kidneys or central nervous system (CNS) (2) , which complicates establishing the correct diagnosis. Generally, ARF is a diagnosis of exclusion because many systemic diseases that closely resemble ARF, such as juvenile rheumatoid arthritis, infective endocarditis, or systemic lupus erythematosus, must be considered. (1) We report a 10-year-old boy with ARF that initially presented with unusual and rare manifestations of abdominal pain and acute meningoencephalitis. This case emphasizes the question of various ARF clinical manifestations, apart from those ones included in the clinical criteria.

Acute rheumatic fever ; acute meningoencephalitis ; child

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