Silva Veiga Ricardo, Marques Marta, Fonseca José, Ventura Hugo, Silva Marques Joana
Internal Medicine, Hospital São Teotónio, Viseu, PRT.
Infectious Diseases, Hospital São Teotónio, Viseu, PRT.
Cureus. 2024 Oct 30;16(10):e72687. doi: 10.7759/cureus.72687. eCollection 2024 Oct.
The authors present the case of a 71-year-old man with fever, polyarthralgia, and migratory arthritis after the diagnosis of pharyngitis one week earlier. The patient showed unequivocal evidence of recent group A streptococcal (GAS) infection with a significantly elevated antistreptolysin O (ASO) titer that normalized during follow-up. The symptoms, laboratory results, and clinical examination raised uncertainty about whether the patient was suffering from acute rheumatic fever (ARF) or post-streptococcal reactive arthritis (PSReA), as the patient exhibited characteristics of both conditions. These two conditions share a similar origin and, in some cases, lack clear distinction, suggesting that they may be part of the same disease spectrum. The case emphasizes the importance of considering ARF in patients with suspected recent streptococcal infections who present with polyarthralgia and fever, ensuring early and appropriate treatment to prevent complications.
作者报告了一例71岁男性病例，该患者在一周前被诊断为咽炎后出现发热、多关节痛和游走性关节炎。患者有明确的近期A组链球菌（GAS）感染证据，抗链球菌溶血素O（ASO）滴度显著升高，随访期间恢复正常。由于患者同时表现出这两种疾病的特征，其症状、实验室检查结果及临床检查结果引发了关于该患者是患有急性风湿热（ARF）还是链球菌感染后反应性关节炎（PSReA）的疑问。这两种疾病起源相似，在某些情况下缺乏明确区分，提示它们可能属于同一疾病谱。该病例强调了对于疑似近期链球菌感染且伴有多关节痛和发热的患者考虑ARF的重要性，确保早期进行适当治疗以预防并发症。
