ACUTE RHEUMATIC FEVER – A CASE REPORT


ACUTE RHEUMATIC FEVER – A CASE REPORT. My excuse for bringing this report before this august body is that it is a simple clear-cut case of rheumatic fever which was cured by a single remedy and time. This twelve-year-old girl was brought to y office on April 10th of this year complaining that during her second menstrual period, which was then present, she had mild cramps in the abdomen, a lumbar backache and pain and swelling of the left knee which was worse on walking or straightening her leg.


My excuse for bringing this report before this august body is that it is a simple clear-cut case of rheumatic fever which was cured by a single remedy and time.

This twelve-year-old girl was brought to y office on April 10th of this year complaining that during her second menstrual period, which was then present, she had mild cramps in the abdomen, a lumbar backache and pain and swelling of the left knee which was worse on walking or straightening her leg. She also had been running a temperature of 101-102 daily for three days that had continued to go to school.

On examination I found the left knee moderately swollen and slightly tender. The right tonsil enlarged and injected although not sore. Her heart was fast but regular temperature 101.6. I prescribed Kali carb. 200., not knowing how much of her

symptomatology was associated with her menstruation.

However, I did send her to the laboratory for a blood count, urine analysis and sedimentation rate.

The urine showed a trace of albumin and 50 red cells per high- power field. The white count was 15,900 and the sedimentation rate rate it was obviously acute rheumatic fever.

Fortunately, I had received these laboratory reports by phone Saturday evening. Sunday morning early, the girl’s mother phoned me to say that her daughter had not had more than one hour’s sleep all night and was crying loudly and bitterly from pain and exhaustion. I found that the left knee was more swollen and painful, the left big toe swelling and tender and she complained of pains in the shoulders and small of the back. The pains were cutting and worse on motion and no better from heat. She sweated freely while asleep. During the night she would drop off to sleep but awake in a few minutes screaming with pain in her sore joints. The pains would gradually subsides after waking and after an hour or more she would drop to sleep again only to awake in extreme pain within a few minutes.

This time, prescribing on the symptoms, I gave her Lachesis 1000. and S.L. tablets every two hours.

The next morning, April 13th, the temperature was only 99.6. She had slept well with no aggravation, although she had awakened once with a nose bleed of dark blood from her left nostril. The pains and tenderness of the joints were much less. April 14th, temperature 98.6, moves easily bed and feels fine. April 16th, no complaints, no temperature, no pain. Less swelling of the left knee.

April 21st, no pain, no swelling, no soreness. Heart regular, normal, rate 75. April 27th, no complaint. Heart same. Sediment rate 14. May 5th up and about the house. Heart faster, 90. Feels and looks well.

May 9, Sediment rate 11, Electrocardiogram normal. Right tonsil large with injected vessels. A mottled red discoloration of chest and upper arms following a hot bath. Temperature normal. Pulse 90. Blood pressure 110/58. Rx Lach. 1000.

May 15th, no complaint. Pulse 90 but heart sounds normal. Sediment rate 10 (normal). Looks and feels well. To return to school. May 22nd, gaining weight, looks well. Pulse 90.

June 6th is fine. No troubles, Heart rate 78 and normal. Right tonsil remains large. 1800 GLENVIEW.

GLENVIEW, ILLINOIS.

Donald G. Gladish