I would seriously consider managing this as a case of rheumatic
fever. Plenty of criteria have been met, we just need proof of
streptococcal infection. http://www.gpnotebook.co.uk/simplepage.cfm?ID=-
1294991341&linkID=29747&cook=yes
I'd ask the microbiologist to see if the technicians could do another
ASOT titre today (or other specific test) or send serum by courier to a
lab that could.
A combination of penicillin and prednisolone wouldn't be a bad start
today, and see if the CRP has fallen tomorrow.
Rapid Response:
Erythema marginatum ?
'A rash not evident during ward rounds'
A rash that comes and goes in the early stages of rheumatic fever.
http://www.gpnotebook.co.uk/simplepage.cfm?ID=-2140471290
I would seriously consider managing this as a case of rheumatic
fever. Plenty of criteria have been met, we just need proof of
streptococcal infection.
http://www.gpnotebook.co.uk/simplepage.cfm?ID=-
1294991341&linkID=29747&cook=yes
I'd ask the microbiologist to see if the technicians could do another
ASOT titre today (or other specific test) or send serum by courier to a
lab that could.
A combination of penicillin and prednisolone wouldn't be a bad start
today, and see if the CRP has fallen tomorrow.
Competing interests:
None declared
Competing interests: No competing interests