Nakauyaca AV

Ralph AP

Majoni SW

Kangaharan N

2019-09-16

We report a case of acute rheumatic fever with severe pancarditis occurring simultaneously with probable acute post-streptococcal glomerulonephritis in a previously well, Australian Aboriginal, 29-year-old male. These autoimmune streptococcal sequelae are usually considered pathogenetically distinct, and concurrence has not previously been reported from this high-burden setting. We hypothesize that a single type of infecting group A Streptococcus (StrepA) triggered both autoimmune sequelae. Salient features included mitral and aortic regurgitation that worsened during the acute illness, painful pericarditis, and high troponin; severe acute kidney injury with oliguria, hematuria, and macroalbuminuria; reduced complement (C3); and elevated streptococcal serology. The case highlights important diagnostic and management challenges. It also illustrates the serious morbidity impact of the complications of StrepA.

Division of Medicine, Department of General Medicine, Royal Darwin Hospital, Northern Territory Medical Program, Flinders University of South Australia..

Division of Medicine, Department of Infectious Diseases, Royal Darwin Hospital, Tiwi, Australia..

Division of Medicine, Department of Nephrology, Royal Darwin Hospital, Tiwi, Australia..

Division of Medicine, Department of Cardiology, Royal Darwin Hospital, Tiwi, Australia..

The American journal of tropical medicine and hygiene 2019-09-16

https://pubmed.ncbi.nlm.nih.gov/31516109/?otool=iaurydwlib

https://hdl.handle.net/10137/7796

Case Report: Concurrent Rheumatic Fever and Acute Post-Streptococcal Glomerulonephritis in a High-Burden Setting.

Journal Article

Publication