Prolonged PR Interval and Erythema Marginatum in a Child with Acute Rheumatic Fever

A 9-year-old girl presented to the emergency department with bilateral hip pain. Eight days before onset, she had fever and sore throat that recovered spontaneously. On physical examination, tenderness of both hip joints was observed but no heart murmur. Body temperature was 36.8 °C. Blood tests showed elevated C-reactive protein (4.4 mg/dL) and antistreptolysin O titer (4540 IU/mL). Throat culture revealed Streptococcus pyogenes (M3 serotype [emm3.95 genotype] was isolated). A 12-lead standard electrocardiogram revealed a longer PR interval than that before onset (Figure  1, A and B).

Source: The Journal of Pediatrics - June 18, 2019 Category: Pediatrics Authors: Toshihiro Matsui, Kenichi Yamaguchi, Tadayoshi Ikebe, Saori Aiga, Isao Kusakawa Tags: Insights and Images Source Type: research