rheumatic fever

  : : My daughter who is a competitive gymnast was diagnosed with "reactive arthritis due to
  : : a strep infection."  Prior to this she had a dog bite and had been on antibiotics
  : : amoxycillin and was near end of that treatment when she apparently contracted a strep
  : : infection at school. The residual antibiotic apparently masked all the tests they gave
  : : my daughter while in the hospital: a whole body nuclear scan, throat culture, etc so they
  : : did not give her any antibiotics/tylenol despite her fever. Once the fever became low grade for
  : : approximately half a day they released her. She had a relapse and what started as just
  : : pain in the hips, now involved her lower back, right wrist, knees, etc. Before we could
  : : get the appointment to the specialist her hands peeled (sloughed off). The specialist gave
  : : tolectin and overnight her pain was gone and she was fine.  The doctor mentioned how the
  : : peeling hands were reminiscent of rheumatic & scarlet fever but stopped shy of actually
  : : stating she had rheumatic fever.  She did followup care for 6 months but being a gymnast
  : : they felt she was "so flexible" but in actuality she did lose some rotation in her hips.
  : : This occurred almost 3yrs ago and recently I learned more about rheumatic fever. The specialist
  : : said if the joint pain ever returned to immediately go to them and not go through our HMO
  : : process. Did my daughter have "rheumatic fever"?  Should I routinely have my daughter's
  : : heart checked out?  She is now 14 (almost 15) yrs old and still a competitive junior
  : : olympic gymnast. My concern is she may collapse suddenly like that ice skater a few yrs ago.
  :

[Cleveland Clinic, MD]

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Dear Ms. Myers-Cruz,
Sydenham's chorea is a movement disorder chacterized by slow jerky movements of the arms and head.  Soft tissue damage is probably related more to the joints.  The test to check for heart damage is called an echocardiogram.  I'm not sure what the significance of the virus is.  I hope everything turns out OK for your daughter.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.