CASE HISTORY 2

A 6 year old female awakened with pain and swelling in the right ankle. Four weeks ago she had a febrile illness with a sore throat and headache and was treated with amoxicillin. On admission, she had a warm, swollen right ankle and a new systolic heart murmur thought to be consistent with mitral regurgitation.

QUESTIONS

 1. The patient previously had a sore throat and although we do not have culture results from that illness, what pathogen would likely have grown from her throat culture?  Answer 

2. What is the relationship between her pharyngitis and the subsequent development of joint problem? What is your diagnosis and why?  Answer

3. What is Rheumatic fever?  Answer

4. What hemolysins does this organism produce which help to identify infection with this organism?  Answer

5. In the absence of positive culture what other evidence can you seek for recent prior Streptococcus pyogenes infection?  Answer

6.What is the pathogenesis of rheumatic fever ?  Answer

7. What are the other virulence factors of  Streptococcus pyogenes ?  Answer

8. What are the clinical presentations of group A streptococcal  infection?  Answer

9. How would you treat this infection?  Answer