CLINICAL MEDICINE

Detailed explanation-1: -The differential diagnosis may include but is not limited to: rheumatoid arthritis, juvenile idiopathic arthritis, septic arthritis, systemic lupus erythematosus, serum sickness, Lyme disease, infective endocarditis, viral myocarditis, Henoch-Schonlein purpura, gout, sarcoidosis, leukemia, and Hodgkin’s disease.

Detailed explanation-2: -Rheumatic fever diagnostic criteria The major diagnostic criteria are carditis, arthritis, chorea, erythema marginatum, and subcutaneous nodules, whereas the minor criteria are arthralgia, hyperpyrexia, high erythrocyte sedimentation rate (ESR), and/or high C-reactive protein (CRP), and prolonged PR interval [9].

Detailed explanation-3: -Rheumatic fever can also be diagnosed if the Jones criteria are not met, in the case of isolated chorea or carditis with an insidious onset, long-term course and inconspicuous progression of lesions, after other causes have been excluded.

Detailed explanation-4: -The most common presenting features of ARF are fever (>90% of patients) and arthritis (75% of patients). The most serious manifestation is carditis (>50% of patients) because it can lead to chronic rheumatic heart disease-while all other clinical features fully resolve, often within weeks.