Akut romatizmal ateşin nadir bir başvuru şekli: Perikardiyal tamponad

Abstract

Acute rheumatic fever is still an important health care problem in developing countries In acute rheumatic fever that presents with pancarditis the most common morbidities develop after involvement of the endocardium Although pericardial disease generally presents with a relatively benign clinical features massive pericardial effusion and associated cardiac tamponade can develop in rare cases and may cause mortality In this study we present the case of a 7 year old male patient who presented with fever and chest pain Physical findings included high temperature 38 5 C deg; tachycardia tachypne deep cardiac sounds and hepatomegaly Electrocardiography findings revealed low QRS voltage and chest x ray was compatible with cardiomegaly Transthoracic echocardiography showed severe pericardial effusion which cause tamponade preventing atrial loading severe mitral insufficiency and mild aortic insufficiency Laboratory results included elevated ASO 580 IU ml and erythrocyte sedimantation rate 80 mm h Primer prophylactic treatment including steroid was administrated and pericardiocentesis was performed Pericardial tamponade associated with acute rheumatic fever is a rare clinical entity and only a few case reports have been reported so far Turk Arch Ped 2013; 48: 342 4