Poststreptococcal Reactive Arthritis and Silent Carditis: A Case Report and Review of the Literature

Abstract

Between 1984 and 1988, a resurgence of acute rheumatic fever (ARF) was reported in several pediatric centers.1-3 During the same time, pediatric cases,4-6 and, recently, adult cases6 of poststreptococcal reactive arthritis (PSRA) have been reported. Although several of these patients had or developed multisystemic manifestations,4,5 none of these cases fully adhered to the guidelines of the revised Jones criteria.7 Thus, these individuals were given the diagnosis of PSRA or poststreptococcal rheumatic syndrome (PSRS) rather than ARF.4-6,8-10 One of the leading causes of acquired pediatric heart disease in North America is carditis of ARF,3 and severe cases can result in congestive heart failure, the need for valve replacement, or death.11