| |
Disease and Resistance: The War Within |
Chapter: 16
|
 |
 |
An Unhappy Dance The doctor was baffled. Here was an alert, charming, and seemingly healthy young girl of 10 who had completely lost control of the right side of her body. It had begun a month earlier when her right hand took on a life of its own, writhing and shaking to its own rhythm. The scary movements worsened, and soon her writing was illegible. Then her gait grew wobbly and the right side of her face grimaced with contortions. Even her tongue was twisted. It was then that the child was brought to the hospital’s emergency room.
The lab performed diagnostic tests for meningitis, brain tumors, and other neurological impairments, but all were fruitless. With a rapidly diminishing list of possibilities, the doctor ordered blood tests for a series of bacterial diseases, even though no symptoms of infection were present. Success finally came—blood tests revealed antibodies against Group A streptococci. The child was suffering from rheumatic fever, a disease that can manifest itself as arthritis, endocarditis, skin nodules, or in the bewildering symptoms she displayed. This particular syndrome is called Sydenham’s chorea (for Thomas Sydenham, who described it in the late 1600s, and the Greek work choreia for dance, a reference to the jerky movements). The syndrome is also known as Saint Vitus’ dance.
Before 1945, rheumatic fever was a fearful cause of death in children, leaving many of the survivors debilitated with damaged hearts. Then, with the linking of streptococci to the disease and with penicillin intervention, the disease waned. Since 1985, however, Group A streptococci have resurfaced in the United States and have exacted a heavy toll (including the life of Muppets creator Jim Henson). Doctors have reported outbreaks of rheumatic fever and other streptococcus-related disorders such as pneumonia, impetigo, and a form of toxic shock syndrome (called "toxic strep syndrome"). Whether the new streptococci are mutants of the older forms or a reappearance of the older forms is uncertain. It is interesting to note that a large percentage of infections arise from breaks in the skin, not normally the mode of entry for Group A streptococci. In late 1993, the streptococci were also related to Kawasaki disease (Chapter 12).
For those affected, it is reassuring to know that penicillin is effective for treating the Group A streptococci. The young girl received a course of penicillin and a month of physical therapy to help relieve the chorea. The chorea would later resurface on the opposite side of her body but that too would disappear. When last seen, the girl was back at school, blissfully unaware of the unusual memories that she had left with her doctors.
|
