[Asymptomatic myocarditis after infection of the upper respiratory tract].
METHODS
A 20-year-old patient was hospitalized with persistent high fever after tonsillitis and swelling of the talocalcanean joint.


METHODS
The ECG showed a partial right bundle branch block pattern and pathological T inversions on the left precordial leads. Cardiac Troponin I levels were slightly elevated and echocardiography revealed a dyscinetic area at the right ventricular apex. The anti-streptolysin titer was elevated.


METHODS
Post-streptococcal rheumatic myocarditis. THERAPY AND FOLLOW-UP: Antibiotic therapy for 2 weeks. The patient showed subjective full recovery after 6 weeks. The anti-streptolysin titer further increases. Nuclear spin tomography of the heart reveal postinflammatory alterations at the apex of the right ventricle.


CONCLUSIONS
Rheumatoid fever is a rare diagnosis in developed countries. This case, however, illustrates that the true prevalence of rheumatoid carditis might be underestimated in the presence of only minimal heart-and joint-specific symptoms.
Ramazzina
C
C
Departement für Innere Medizin, Universitätsspital Basel. ramazzinac@uhbs.ch
Bremerich
J
J
Linka
A
A
Eriksson
U
U
D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000989:Antistreptolysin / Q000032:analysis; D001170:Arthritis, Infectious / Q000150:complications / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009205:Myocarditis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012214:Rheumatic Heart Disease / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013380:Subtalar Joint; D014069:Tonsillitis / Q000150:complications* / Q000382:microbiology; D019210:Troponin I / Q000032:analysis
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019210:Troponin I; D019980:Amoxicillin-Potassium Clavulanate Combination; D000989:Antistreptolysin