GROUP C STREPTOCOCCUS CAUSING RHEUMATIC HEART DISEASE IN A CHILD
GROUP C STREPTOCOCCUS CAUSING RHEUMATIC HEART DISEASE IN A CHILD
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DOI：
10.1016/j.jemermed.2014.12.057
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发表时间：
2015-07-01
影响因子：
1.5
通讯作者：
Patamasucon, Pisespong
中科院分区：
文献类型：
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作者：
Chandnani, Harsha K.;Jain, Renu;Patamasucon, Pisespong
背景资料：人类感染C组链球菌是极其罕见的，并且已经报道了一些病例，其引起急性咽炎、急性肾小球肾炎、皮肤和软组织感染、脓毒性关节炎、骨髓炎、肺炎和菌血症。在儿科，这种细菌已知会引起流行性食源性咽炎、肺炎、心内膜炎和脑膜炎，据报道已在血液、脑膜、鼻窦、指甲、扁桃体周围脓肿和甲状舌管囊肿等中分离出。病例报告：我们的病人是一位7岁的健康女性，她的上半身出现异常运动，面部出现鬼脸，并随着时间的推移而逐渐恶化。初步实验室检查结果显示尿蛋白3+，抗链球菌溶血素-O和抗DNA酶抗体水平升高，超声心动图显示轻度至中度二尖瓣返流。我们描述了一个罕见的情况下，C组链球菌导致风湿性心脏病的儿童，详细回顾了文献有关的诊断和管理这种感染。为什么急诊医生应该意识到这一点？早期识别风湿性心脏病是至关重要的条件的整体结果，因此知识的症状与条件也是必要的。C组链球菌很少与风湿性心脏病相关，大多数儿童急性发作时的常见症状，如舞蹈病、发热、心脏炎和皮疹（边缘红斑），将首先出现在急诊室。提高认识和及时识别，就像对这个孩子所做的那样，将导致对所有患者的这种情况进行适当的随访和适当的管理。(C)2015 Elsevier Inc.
Background: Human infection with group C Streptococcus is extremely rare and a select number of cases have been reported to cause acute pharyngitis, acute glomerulonephritis, skin and soft tissue infections, septic arthritis, osteomyelitis, pneumonitis, and bacteremia. In pediatrics, this bacteria is known to cause epidemic food-borne pharyngitis, pneumonia, endocarditis, and meningitis, and has reportedly been isolated in the blood, meninges, sinuses, fingernail, peritonsillar abscess, and thyroglossal duct cyst, among others. Case Report: Our patient was a 7-year-old previously healthy female who presented with abnormal movements of her upper body and grimaces of her face that progressively worsened over time. Initial laboratory resulted revealed 3+ protein on urinalysis and elevated antistreptolysin-O and anti-DNAse antibody levels, and echocardiogram showed mild-to-moderate mitral regurgitation. We describe a rare case of group C Streptococcus resulting in rheumatic heart disease in a child, with a detailed review of the literature pertaining to the diagnosis and management of this infection. Why Should an Emergency Physician Be Aware of This?: Early recognition of rheumatic heart disease is crucial in the overall outcome of the condition and therefore knowledge of the symptoms associated with condition is also imperative. Group C Streptococcus is rarely associated with rheumatic heart disease and most children exhibiting acute onset of common symptoms, such as chorea, fever, carditis, and rash (erythema margin-atum) will present to the emergency department first. Increased awareness and prompt recognition, as done with this child, will result in proper follow-up and adequate management of this condition in all patients. (C) 2015 Elsevier Inc.