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Pulmonary Involvement in Acute Rheumatic Fever: A Case Report and Literature Review
Rheumatic pneumonia is a pulmonary complication of rheumatic fever, often with grave outcomes. It has been described sporadically in literature, most recently a decade ago. Here, we describe a case of a 12-year-old Native American girl presenting with chest pain, gastrointestinal complaints, and fre...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Cureus
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163343/ https://www.ncbi.nlm.nih.gov/pubmed/32313736 http://dx.doi.org/10.7759/cureus.7295 |
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author | Kenney, Patrick McMullin, Sarah Abdul-Aziz, Rabheh |
author_facet | Kenney, Patrick McMullin, Sarah Abdul-Aziz, Rabheh |
author_sort | Kenney, Patrick |
collection | PubMed |
description | Rheumatic pneumonia is a pulmonary complication of rheumatic fever, often with grave outcomes. It has been described sporadically in literature, most recently a decade ago. Here, we describe a case of a 12-year-old Native American girl presenting with chest pain, gastrointestinal complaints, and frequent nosebleeds. After the initial diagnosis with acute pericarditis, she was found to meet diagnostic criteria for rheumatic fever. Revised Jones criteria met included significantly elevated streptolysin O antibody and anti-DNase B, carditis, arthralgia, fever, and elevated inflammatory markers. Findings complicating the diagnosis were an elevated antinuclear antigen with a family history of systemic lupus erythematosus (SLE), hemoptysis, and a chest CT finding of right lower lobe alveolar hemorrhage as well as right-sided mediastinal adenopathy. The patient was discharged on day nine of admission after a course of high-dose methylprednisolone with prednisone taper, furosemide, enalapril, naproxen, monthly penicillin G injections, and multidisciplinary outpatient follow-up. A repeat chest CT scan three months later showed significant improvement. The pulmonary findings described in our patient are consistent with prior reports of rheumatic pneumonia, however, most prior cases described did not include high-resolution imaging. Our patient recovered well aside from complications secondary to mitral regurgitation, unlike many patients seen in our literature search who died due to early or later complications of pulmonary disease. Although acute rheumatic fever, and its pulmonary complications, is significantly less common than it once was, it remains a disease entity that should remain on the differential for multisystem rheumatic complaints. |
format | Online Article Text |
id | pubmed-7163343 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-71633432020-04-20 Pulmonary Involvement in Acute Rheumatic Fever: A Case Report and Literature Review Kenney, Patrick McMullin, Sarah Abdul-Aziz, Rabheh Cureus Pediatrics Rheumatic pneumonia is a pulmonary complication of rheumatic fever, often with grave outcomes. It has been described sporadically in literature, most recently a decade ago. Here, we describe a case of a 12-year-old Native American girl presenting with chest pain, gastrointestinal complaints, and frequent nosebleeds. After the initial diagnosis with acute pericarditis, she was found to meet diagnostic criteria for rheumatic fever. Revised Jones criteria met included significantly elevated streptolysin O antibody and anti-DNase B, carditis, arthralgia, fever, and elevated inflammatory markers. Findings complicating the diagnosis were an elevated antinuclear antigen with a family history of systemic lupus erythematosus (SLE), hemoptysis, and a chest CT finding of right lower lobe alveolar hemorrhage as well as right-sided mediastinal adenopathy. The patient was discharged on day nine of admission after a course of high-dose methylprednisolone with prednisone taper, furosemide, enalapril, naproxen, monthly penicillin G injections, and multidisciplinary outpatient follow-up. A repeat chest CT scan three months later showed significant improvement. The pulmonary findings described in our patient are consistent with prior reports of rheumatic pneumonia, however, most prior cases described did not include high-resolution imaging. Our patient recovered well aside from complications secondary to mitral regurgitation, unlike many patients seen in our literature search who died due to early or later complications of pulmonary disease. Although acute rheumatic fever, and its pulmonary complications, is significantly less common than it once was, it remains a disease entity that should remain on the differential for multisystem rheumatic complaints. Cureus 2020-03-16 /pmc/articles/PMC7163343/ /pubmed/32313736 http://dx.doi.org/10.7759/cureus.7295 Text en Copyright © 2020, Kenney et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Pediatrics Kenney, Patrick McMullin, Sarah Abdul-Aziz, Rabheh Pulmonary Involvement in Acute Rheumatic Fever: A Case Report and Literature Review |
title | Pulmonary Involvement in Acute Rheumatic Fever: A Case Report and Literature Review |
title_full | Pulmonary Involvement in Acute Rheumatic Fever: A Case Report and Literature Review |
title_fullStr | Pulmonary Involvement in Acute Rheumatic Fever: A Case Report and Literature Review |
title_full_unstemmed | Pulmonary Involvement in Acute Rheumatic Fever: A Case Report and Literature Review |
title_short | Pulmonary Involvement in Acute Rheumatic Fever: A Case Report and Literature Review |
title_sort | pulmonary involvement in acute rheumatic fever: a case report and literature review |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163343/ https://www.ncbi.nlm.nih.gov/pubmed/32313736 http://dx.doi.org/10.7759/cureus.7295 |
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