THE COOCCURRENCE OF ACUTE RHEUMATIC-FEVER AND AIDS

We describe a patient with advanced acquired immunodeficiency syndrome (AIDS) who presented with evidence of carditis, arthritis, and chorea in the setting of fever, and serologic evidence for recent streptococ cal infection. Several features atypical for rheumatic fever were pres ent and included persistently high titer of antistreptolysin O, the si multaneous occurrence of chorea and arthritis, and the presence of cho rea in a sexually mature adult man. The differential diagnosis of arth ritis in a host at risk for human immunodeficiency virus should be exp anded to include acute rheumatic fever, which may manifest atypical fe atures.