Snapshot A 10-year-old girl presents with a fever and migrating joint pains in the knees and elbows. She reports having had a sore throat a few days ago. On physical exam, she is febrile and has barely raised erythematous serpentine-like lesions on her back. A rapid streptococcal test is positive and there is an elevated erythrocyte sedimentation rate. She is given antibiotics for this disease. Introduction Clinical definition login to view 1 more bullet Epidemiology Demographics login to view 2 more bullets Location login to view 2 more bullets Risk factors login to view 2 more bullets Etiology Typically due to inadequate treatment of group A streptococcal infection Pathogenesis login to view 10 more bullets Associated conditions login to view 3 more bullets Presentation Symptoms login to view 3 more bullets Physical exam login to view 9 more bullets Imaging Echocardiography login to view 5 more bullets Studies Positive throat culture or rapid antigen test for Streptococcus Labs login to view 2 more bullets Electrocardiography login to view 2 more bullets Histology login to view 4 more bullets Differential Infective endocarditis login to view 4 more bullets DIAGNOSIS Making the diagnosis login to view 1 more bullet Jones Criteria Major Criteria Minor Criteria Joints (migratory arthritis) O looks like the heart (carditis) Nodules (subcutaneous) Erythema marginatum Sydenham chorea Fever Antecedent strep infection Arthralgias ↑ Erythrocyte sedimentation rate ↑ C-reactive protein First-degree heart block Treatment Management approach login to view 2 more bullets Medical login to view 9 more bullets Complications Rheumatic heart disease Prognosis Occurs 2-3 weeks after pharyngitis, except carditis and chorea login to view 2 more bullets Risk of recurrence decreases with time