{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T10:28:03Z","timestamp":1771064883938,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T00:00:00Z","timestamp":1528070400000},"content-version":"vor","delay-in-days":154,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pediatrics"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>\n                    While the incidence of acute rheumatic fever (ARF) in the United States has declined over the past years, the disease remains one of the causes of severe cardiovascular morbidity in children. The index of suspicion for ARF in health care providers may be low due to decreasing incidence of the disease and clinical presentation that can mimic other conditions. We present the case of a 5\u2010year\u2010old boy with a history of intermittent fevers, fatigue, migratory joint pain, and weight loss following\n                    <jats:italic>group A Streptococcus<\/jats:italic>\n                    pharyngitis. The patient presented to the emergency department twice with the complaints described above. On his 3rd presentation, the workup for his symptoms revealed the diagnosis of acute rheumatic fever with severe mitral and aortic valve regurgitation. The patient was treated with penicillin G benzathine and was started on glucocorticoids for severe carditis. The patient was discharged with recommendations to continue secondary prophylaxis with penicillin G benzathine every 4 weeks for the next 10 years. This case illustrates importance of primary prevention of acute rheumatic fever with adequate antibiotic treatment of\n                    <jats:italic>group A Streptococcus<\/jats:italic>\n                    pharyngitis. Parents should also receive information and education that a child with a previous attack of ARF has higher risk for a recurrent attack of rheumatic fever. This can lead to development of severe rheumatic heart disease. Prevention of recurrent ARF requires continuous antimicrobial prophylaxis. Follow\u2010up with a cardiologist every 1\u20102 years is essential to assess the heart for valve damage.\n                  <\/jats:p>","DOI":"10.1155\/2018\/9467131","type":"journal-article","created":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T19:32:28Z","timestamp":1528140748000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Delayed Diagnosis of Acute Rheumatic Fever in a Patient with Multiple Emergency Department Visits"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9997-7238","authenticated-orcid":false,"given":"Inna","family":"Kaminecki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renuka","family":"Verma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Brunetto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loyda I.","family":"Rivera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,4]]},"reference":[{"key":"e_1_2_6_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(05)70267-x"},{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis422"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03490150121036"},{"key":"e_1_2_6_4_2","first-page":"1","article-title":"Rheumatic fever and rheumatic heart disease","volume":"923","author":"World Health Organization","year":"2004","journal-title":"World Health Organization Technical Report Series"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000205"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.191959"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.2147\/clep.s12977"},{"key":"e_1_2_6_8_2","first-page":"59","article-title":"Rheumatic fever diagnosis, management, and secondary prevention: a New Zealand guideline","volume":"121","author":"Atatoa-Carr P.","year":"2008","journal-title":"New Zealand Medical Journal"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2008.157107"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e3181d30e96"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12786"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis847"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5240.1628"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1590\/s0004-282x2002000300006"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2007.tb01059.x"}],"container-title":["Case Reports in Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cripe\/2018\/9467131.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cripe\/2018\/9467131.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2018\/9467131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:18:04Z","timestamp":1762474684000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2018\/9467131"}},"subtitle":[],"editor":[{"given":"Larry A.","family":"Rhodes","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1155\/2018\/9467131"],"URL":"https:\/\/doi.org\/10.1155\/2018\/9467131","archive":["Portico"],"relation":{},"ISSN":["2090-6803","2090-6811"],"issn-type":[{"value":"2090-6803","type":"print"},{"value":"2090-6811","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1]]},"assertion":[{"value":"2018-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"9467131"}}