A 12 year old boy is brought to the clinic because of fever, migratory joint pain, and shortness of breath 3 weeks after a sore throat that resolved without treatment. Examination shows a new holosystolic murmur at the apex and tender swollen knees and ankles. Which of the following is the most likely mechanism of his cardiac disease?
- A)Direct bacterial invasion of the valve leaflets
- B)Autoimmune cross reactivity to streptococcal M proteinGABARITO
- C)Fibrocalcific degeneration due to aging
- D)Toxin mediated endothelial injury by Corynebacterium
- E)Immune complex deposition from chronic hepatitis
Explicação
Autoimmune cross reactivity to streptococcal M protein is correct. Acute rheumatic fever follows untreated group A streptococcal pharyngitis and causes pancarditis through molecular mimicry. The migratory polyarthritis and new mitral regurgitation murmur stron... Ver explicação completa e trilha adaptativa →