Dr. Dorfman: The patient to be presented is a 9-year-old white female who was first admitted to Bobs Roberts Hospital on October 7, 1954. During a large part of her illness she was on the service of Dr. Klara J. Prec.
Her past history, family history, birth history and early development are not pertinent to the present complaint. The present illness is related to a disease that had its onset with fever and sore throat at the age of 4 years. Despite therapy with unidentified antibiotics, only poor recovery occurred. It was recognized a week later that she had anemia and an elevated erythrocyte sedimentation rate.
The patient was hospitalized in another hospital with a diagnosis of acute rheumatic fever. At this time she was treated with antibiotics and acetylsalicylic acid and after 4 weeks was discharged to her home.
After 1 week at home, her parents felt she was not doing well and the patient was admitted to La Rabida Jackson Park Sanitarium at that time. At the time of this admission in 1951, the pulse rate was elevated and a grade 3 systolic murmur was heard over most of the precordium. The heart was markedly enlarged as measured by roentgenogram. A throat culture was positive for beta-hemolytic streptococcus.
During the following 4 months she remained at La Rabida. The streptococcal infection was eradicated. She was treated intermittently with salicylates and had a steady, progressive improvement, so that at the end of this time she was discharged with no evidence of active rheumatic fever, but evidence of mitral insufficiency was present.
- Copyright © 1957 by the American Academy of Pediatrics