Tuesday, October 9, 2012

Block 2 Case 19


A 12 year old female comes to your office with her mother because of a slightly raised painless rash which developed yesterday morning.  She notes swollen joints, palpitations, and jerky uncontrolled movements.  You discover that she is visiting from Argentina and had a sore throat and fever 3 weeks prior.  She has a temperature of 103.1 in the office today.


Below are tissue sections from heart biopsy.








What key features are present in the biopsy specimens?
1   

What is the diagnosis?


What is the pathogenesis?


What are the Jones criteria for RF? What do you need for diagnosis?

Major Criteria:

Minor:
      

What organism would grow following cardiac culture?
    

The patient returned after several more episodes of rheumatic heart disease and died from complications from heart failure.  Autopsy specimens are shown below:





What key findings are present in the autopsy specimens?

What valves are typically affected in rheumatic heart disease?
     


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