[Rheumatic fever in a four-year-old girl]. / Mitralklapsinsufficiens efter reumatisk feberhos et barn.

Rheumatic fever (RF) is a systemic autoimmune response 2-4 weeks after a tonsillopharyngitis with group A beta-haemolytic Streptococcus. The disease may cause arthritis, carditis, chorea, erythema marginatum and subcutaneous noduli. Due to improved hygiene, living conditions and use of antibiotics, RF is a rare disease in Denmark today. The variable symptoms and low incidence is a diagnostic challenge. In this article, we present a case of RF in a four-year-old girl and provide an overview of diagnostic criteria and treatment.

[Incomplete Kawasaki syndrome with a coronary artery aneurysm in an infant].

We report a four-month-old boy with incomplete Kawasaki syndrome. He developed a coronary artery aneurysm. Incomplete Kawasaki syndrome is rare in Denmark, and only reported in five patient cases in the past 25 years. It is difficult to diagnose Kawasaki disease; early diagnosis and treatment reduces the risk for cardiac sequel. In lack of diagnostic test, we recommend that the algorithm from the American Heart Association to diagnose incomplete Kawasaki is implemented in Denmark. The algorithm is based on classic clinical features, echocardiography and laboratory findings.

[Myocarditis with massive troponin T elevation caused by varicella-zoster infection in a teenager]. / Myokarditis med massivt troponin T-udslip forårsaget af varicella zoster-infektion hos teenager.

Chickenpox is a common childhood infection caused by the varicella-zoster virus. Complications are rare. We report on a 15-year-old boy who developed myocarditis during a varicella-zoster infection. The patient presented with severe chest pain, examinations revealed significant ST-elevations in the electrocardiogram and elevated troponin T levels up to 690 ng/l. Echocardiography showed decreased left ventricular contractility without coinciding pericarditis. He remained haemodynamically stable on analgesics and aciclovir and was discharged nine days later with normalized echocardiography and troponin T levels.

[Neonatal skull fracture]. / Neonatal kraniefraktur.

During the latest decades the incidence of birth traumas has decreased significantly. Even so the traumas still contribute to an increased mortality and morbidity. We present a case of spontaneous neonatal skull fracture following a normal vaginal delivery. Abnormal facial structure was seen, and the fracture was identified with an MRI. The fractures healed without neurosurgical intervention. Case reports show that even in uncomplicated vaginal deliveries skull fractures can be seen and should be suspected in children with facial abnormalities.