Scheurer C D, Peters A C, van Furth A M
Academisch Ziekenhuis, afd. Kinderneurologie, Utrecht.
Ned Tijdschr Geneeskd. 1998 Dec 19;142(51):2789-92.
A nine-year-old girl had acute choreatic symptoms in her face and limbs, after a throat infection 6 weeks previously. On auscultation of the heart a systolic murmur was found and echocardiography showed mitral valve incompetence. There was a positive anti-deoxyribonuclease B titre in the serum, providing evidence of a previously contracted streptococcal infection. Both chorea and acquired carditis are major criteria for the diagnosis of acute rheumatic fever. The course was characterized--as it usually is--by spontaneous, gradual resolution of the symptoms. Protracted penicillin prophylaxis is indicated to prevent recurrence of acute rheumatic fever and cardiac valvular damage.
一名9岁女孩在6周前咽喉感染后,面部和四肢出现急性舞蹈症症状。心脏听诊发现收缩期杂音,超声心动图显示二尖瓣关闭不全。血清中抗脱氧核糖核酸酶B滴度呈阳性,证明此前感染过链球菌。舞蹈症和获得性心脏炎均为急性风湿热诊断的主要标准。病程的特点是——通常也是如此——症状自发、逐渐缓解。需长期使用青霉素预防,以防止急性风湿热复发和心脏瓣膜损害。