Atrioventricular block complicating acute streptococcal tonsillitis.

A 38 year old woman presented with severe weakness, high fever, and sore throat. Physical examination showed follicular tonsillitis and bradycardia caused by a atrioventricular block. Within 24 hours a normal sinus rhythm was regained but slight transient ST-T changes compatible with myocarditis were evident. Throat culture grew Streptococcus haemolyticus group A.