A 12 year old boy is brought to the clinic because of fever and migratory pain in both knees and ankles. Three weeks ago he had a sore throat that was not treated. Examination reveals a new holosystolic murmur at the apex and several painless subcutaneous nodules over the elbows. Which of the following is the most likely diagnosis?

  1. A)Acute rheumatic feverGABARITO
  2. B)Aortic dissection
  3. C)Restrictive cardiomyopathy
  4. D)Infective endocarditis
  5. E)Dilated cardiomyopathy

Explicação

Acute rheumatic fever is correct. This child has a classic post streptococcal syndrome with migratory polyarthritis, carditis, and subcutaneous nodules appearing weeks after untreated pharyngitis. Molecular mimicry leads to a type II hypersensitivity reaction ... Ver explicação completa e trilha adaptativa →

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