Çocuk Sağlığı ve Hastalıkları Dergisi 2006 , Vol 49 , Num 3
Acute rheumatic fever associated with acute poststreptococcal glomerulonephritis: a case report
Lale Camcı1, Zübeyir Kılıç2, Birsen Uçar2, Ali İhsan Bulut3, Bilal Yıldız4
1Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Pediatri Araştırma Görevlisi
2Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Pediatri Profesörü
3Şanlıurfa Devlet Hastanesi Pediatri Uzmanı
4Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Pediatri Öğretim Görevlisi
Camcı L, Kılıç Z, Uçar B, Bulut Aİ, Yıldız B. (Department of Pediatrics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey). Acute rheumatic fever associated with acute poststreptococcal glomerulonephritis: a case report. Çocuk Sağlığı ve Hastalıkları Dergisi 2006; 49: 217-220.

Acute rheumatic fever (ARF) and acute poststreptococcal glomerulonephritis (APSGN) are two distinct nonsupuprative complications of streptococcal infection. Since they occur with different streptococcal serotypes, the occurrence of ARF and APSGN in the same patient is rare. We report a 4.5-year-old boy who presented with typical clinical findings of ARF and APSGN after streptococcal throat infection. The patient was admitted to our hospital with fever and respiratory distress. His medical history revealed a throat infection 10 days ago and arthralgia at the right knee of two days’ duration starting five days ago. Physical examination revealed a body temperature of 37.5º C, heart rate of 192/min, blood pressure of 144/102 mmHg, and respiratory rate of 52/min. A grade 3/6 apical systolic murmur and gallop rhythm were detected on cardiac auscultation. He had dyspnea, bilateral diffuse rales on pulmonary oscultation and edema in pretibial region. Blood work-up showed high erythrocyte sedimentation rate and antistreptolysin - O (ASO) titer and low complement levels. Urinalysis showed microscopic hematuria and mild proteinuria. Echocardiographic examination demonstrated mitral and aortic insufficiency. A patient with both ARF and APSGN is presented here because of its rarity and the related literature is reviewed. Anahtar Kelimeler : Akut romatizmal ateş, poststreptokoksik akut glomerülonefrit, acute rheumatic fever, acute poststreptococcal glomerulonephritis

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