Chronic Carditis in a Child of Nineteen Months

Chronic carditis in infancy is so rare that the following case, which presented both clinical and pathological problems, is considered worth reporting. Case HistoryA.N., a boy and the only child, was stated to have been a fortnight premature and to have weighed 5j lb. at birth.Breast fed for one month, he was then given bottle feeds as his mother had insufficient milk.On this he thrived, and sub- sequent progress was normal with no history of any illness until his last.At 16 months he weighed 21 lb., and at 18 months he had 12 teeth and could walk and speak a few words.Both parents were healthy, and there was no history of illness during the mother's pregnancy.Three weeks before admission, at the age of 19 months, the child became fractious and appeared unwell.The only abnormal physical sign was stiff and painful middle fingers, but the general condition deteriorated and he was eventually sent to hospital.Clinical Examination.On admission the child was lying quietly, but resented disturbances.The cheeks and mucous membranes were pale, the limbs hypotonic, and the nails spoon-shaped.There was sweating and apparent recent loss of weight, the actual weight being 18 lb.3 oz.The skull