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Article
March 1923

A CASE OF RHEUMATIC FEVER WITH CEREBRAL SYMPTOMS SIMULATING ENCEPHALITIS LETHARGICA

Arch Intern Med (Chic). 1923;31(3):411-412. doi:10.1001/archinte.1923.00110150110008
Abstract

History.  —Mrs. J. F., aged 54, had a sharp attack of tonsillitis, Feb. 14, 1922, the temperature rising to 102.4 F., and culture showing Streptococcus viridans. Two days later she began to have joint pain, and large, elevated, red and tender nodes on the skin of the neck, and over the shins, typically an erythema nodosum.

Past History.  —She had had typhoid fever, a severe case, at the age of 10, bronchopneumonia at 19, and frequent attacks of tonsillitis; headaches of a migrainal type, hemicranial in nature, with occasional hemianopsia.She first consulted me in November, 1921, complaining of numbness and tingling in the arms, and legs, particularly in the left arm. One month before there was temporary loss of power of about one hour's duration. She was also confused mentally at this time. Her menstrual history began at 16, and was uneventful. Her marital history showed numerous miscarriages. She

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