A Case Report: Acute Rheumatic Fever or Something More?

Area of Science:

• Rheumatology
• Pediatrics
• Infectious Diseases

Background:

• Acute rheumatic fever (ARF) is an autoimmune sequela of group A Streptococcus (GAS) infection.
• Subcutaneous nodules are an uncommon clinical manifestation of ARF, reported in 0%-10% of cases.

Observation:

• A 13-year-old female presented with a three-month history of non-migratory polyarticular joint pain and subcutaneous nodules.
• The patient exhibited poor response to ibuprofen and presented with carditis, fulfilling revised Jones criteria (2015).

Findings:

• The diagnosis of acute rheumatic fever was established based on clinical presentation and diagnostic criteria.
• Successful management included long-term penicillin prophylaxis after initial treatment.

Implications:

• This case underscores the importance of recognizing rare manifestations like subcutaneous nodules in diagnosing ARF.
• Prompt diagnosis and management are crucial for preventing long-term sequelae in pediatric patients.