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Introduction: rheumatic fever is the most important cause of cardiopaties in children worldwide which is why it is very
important to recognize the signs and symptoms to prevent long- term valvular damage.
Clinic Case: we present the case of an 8 year-old female patient who came with right ankle arthritis of 24 hours of evolution with a
38°C fever not associated to trauma and a history of an untreated pharyngitis and non quantified fever two weeks prior to the visit.
At her second day in the hospital, she presented arthritis in left wrist, right knee, third and fourth finger of the left hand, which
resolved three days later, followed by arthritis in all fingers of right hand and left foot associated to fever higher than 38°C
which persisted for ten days. The next day, a holosystolic murmur II/VI on mitral area was ausculted. The laboratory results showed:
negative anti-DNA, leukocytosis, positive titer of antistreptolysin O, erythrocyte sedimentation rate and C-reactive protein were
elevated. The thorax radiography at the seventh day showed increase of the cardiac silhouette. The echocardiography showed
moderate mitral insufficiency, dilatation of pulmonary veins and mild-moderate pericardial effusion. The electrocardiography showed prolonged PR interval.
Discussion: The polyarthritis, pancarditis give us mayor Jones diagnostic criteria; fever, arthralgia, prolonged PR interval and
acute phase reactants give us minor diagnostic criteria which associated to the history of untreated pharyngitis and positive
titer of antistreptolysin O suggest the diagnosis of rheumatic fever.
