Acute rheumatic fever

Case contributed by David Preston
Diagnosis probable


This Indigenous Australian was admitted to a rural hospital with high fevers and shortness of breath. Originally treated as having pneumonia.

Patient Data

Age: 16 years
Gender: Male

Plain chest film shows bilateral increased interstitial markings. Heart shadow is obscured although appears enlarged. Left sided pleural effusion noted.

After referral to a tertiary hospital, the patient was intubated and required inotropes. An echo was obtained which showed torrential regurgitation of the mitral and aortic valves. A diagnosis of rheumatic heart disease was made. Treatment included high dose aspirin.


The patient is intubated and ventilated. Cardiomegaly is now clearly seen. 

The patient went to theater for mitral and aortic valve replacement. 


Post thoracotomy. Valvular protheses noted. ETT, NGT, CVC and intercostal catheter present. 

Case Discussion

Recovery was swift and transfer to the ward then back home soon followed.

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