Cocuk Sagligi ve Hastaliklari Dergisi, cilt.49, sa.3, ss.217-220, 2006 (Scopus)
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 37.5°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.