Cardiac Tamponade as a Rare Form of Presentation of Rheumatic Carditis

Rheumatic Fever Presenting as Recurrent Pericarditis and Cardiac Tamponade

“…Of additional interest, pericarditis in rheumatic carditis is characterized by fibrous sterile exudate, which coincides with the fibrous strands seen on echocardiogram and pericardial fluid that was cultured and remained sterile. 6 Overall, only 5% to 10% of all patients with rheumatic fever develop clinically detectable pericarditis, one of the known, but less common findings in rheumatic carditis. 6,7 When present, pericarditis is most often observed with pancarditis.…”

“…6 Overall, only 5% to 10% of all patients with rheumatic fever develop clinically detectable pericarditis, one of the known, but less common findings in rheumatic carditis. 6,7 When present, pericarditis is most often observed with pancarditis. 7 However, there have been no reports in the literature of rheumatic fever presenting as recurrent pericarditis.…”

“…The literature also contains only four previously documented cases of rheumatic fever presenting as cardiac tamponade, of which none were in the United States. 6,[8][9][10] Though the prevalence of rheumatic fever has been dwindling in the United States in the past 50 years, it is still an important diagnosis and should be on the pediatricians' differential for children presenting with pericarditis and/or cardiac tamponade that are found to have mitral or aortic valvulitis. 1…”

“…Of additional interest, pericarditis in rheumatic carditis is characterized by fibrous sterile exudate, which coincides with the fibrous strands seen on echocardiogram and pericardial fluid that was cultured and remained sterile. 6…”

“…Additionally, literature review contains only 4 previously documented cases of rheumatic fever presenting as cardiac tamponade. 6,8-10 These 4 cases occurred in a 12-year-old female in Singapore, 12-year-old female in Brazil, and a 12-year-old female and 7-year-old male from Turkey. 6,8-10 Each patient presented in cardiac tamponade and required pericardiocentesis.…”