TMSS Medical College Journal

Rheumatic fever and post streptococcal glomeruloneoritis are both very serious consequences of rheumatogenic and nephritogenic strains of group A beta hemolytic streptococcus infections. It is a unique coincidence for both conditions to be present in a patient at the same time. We report a case of acute rheumatic fever occurring simultaneously with acute post streptococcal glomeruloneoritis in a previously well 6-year-old boy. Salient features include arthritis of multiple large joints, peri-orbital and ankle edema, oliguria, moderate poroteinuria, reduced complement (C3); and elevated streptococcal serology. The case highlights the importance of early recognition and diagnostic challenges to prevent complications that may follow if not treated.

Acute Rheumatic Fever (ARF) and Acute Post streptococcal glomerulonephritis (APSGN) occurs most commonly in children aged between 5 and 15 year as a sequelae to group A beta hemolytic streptococcus (GABHS) infections as tonsillitis, pharyngitis or skin infection caused by S. pyogenes.' Although the co-occurrence of both in the same patient is extremely rare, several pediatric cases have been documented as literatures so far.’ Here we present this interesting case of acute RF with concurrent APSGN in a 6-year-old child associated with hypertension and congestive heart failure treated successfully.