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Case Reports
. 2025 Mar 5;30(5):103178.
doi: 10.1016/j.jaccas.2024.103178.

Acute Rheumatic Fever in a Low Prevalence Setting

Mark Coyle  1 , Aimee McGreal  2 , John McCormick  3 , Oisin Galvin  3 , Angela McInerney  3 , Andrea Holmes  2 , Yvonne Smyth  3
Affiliations
Case Reports

Acute Rheumatic Fever in a Low Prevalence Setting

Mark Coyle et al. JACC Case Rep. .

Abstract

Background: Acute rheumatic fever is a systemic inflammatory condition caused by beta-hemolytic streptococcal infection. Its prevalence in high-income countries has fallen significantly as a result of widespread antibiotic use and improved living conditions.

Case summary: We report the case of an 18-year-old, otherwise healthy, Irish woman who presented to an Irish hospital with fever and general malaise on a background of recurrent pharyngitis. Her condition rapidly deteriorated in the hospital and she developed septic shock requiring intensive care admission for organ support. Investigations confirmed pancarditis secondary to acute rheumatic fever, which was ultimately treated with antibiotics and corticosteroids.

Discussion: This case highlights that acute rheumatic fever can present with multiple nonspecific symptoms, in unexpected populations, including in the developed world. Early diagnosis and treatment initiation of antimicrobial therapy and corticosteroids is imperative for optimal overall outcomes in rheumatic heart disease.

Keywords: acute heart failure; mitral valve; rheumatic heart disease.

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Conflict of interest statement

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

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Graphical abstract
Figure 1
Figure 1
Palmar Rash
Figure 2
Figure 2
Admission Electrocardiograph
Figure 3
Figure 3
Mitral Regurgitation on Transesophageal Echocardiogram
See this image and copyright information in PMC

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