Fibrinous Pericardial Effusion and Valvulitis Secondary to Previous Acute Rheumatic Fever: An Unusual Clinical Presentation

Abstract

Rheumatic heart disease, a sequela to acute rheumatic fever (ARF), is a major cause of acquired heart disease in children and young adults in developing countries. Valvular disease of variable severity, heart failure, and pericarditis has been observed in patients with rheumatic heart disease. A 12-year-old female patient presented with fever presented for 3 days, continuing for fatigue, exhaustion, and chest pain. Echocardiography revealed a pericardial effusion with a 24-mm-thick fibrin accumulation in the neighborhood of the left ventricle. Review of the patient’s medical history revealed that about 3 months earlier the patient had experienced migrating swelling, erythema, and pain of the ankles and knees that lasted for 1 week. Here, we present an ARF patient with an unusual clinical presentation who thought to have an attack of acute rheumatic fever 3 months earlier and was presented with fibrinous pericardial effusion.

Keywords

• Acute rheumatic fever
• rheumatic heart disease
• pericardial effusion
• adolescent