A 12-year-old girl is brought to the physician by her mother because of a 2-day history of high fever and swelling of the left ankle and knee. She had a sore throat 3 weeks ago. There is no family history of serious illness. Her immunizations are up-to-date. She appears ill. Her temperature is 38.8°C (102.3°F), pulse is 87/min, and blood pressure is 98/62 mm Hg. Examination shows swelling and tenderness of the left ankle and knee; range of motion is limited. Lungs are clear to auscultation. A grade 3/6 holosystolic murmur is heard best at the apex. Abdominal examination shows no abnormalities. Antistreptolysin O titers are 400 Todd units/mL (normal:

Question

A 12-year-old girl is brought to the physician by her mother because of a 2-day history of high fever and swelling of the left ankle and knee. She had a sore throat 3 weeks ago. There is no family history of serious illness. Her immunizations are up-to-date. She appears ill. Her temperature is 38.8°C (102.3°F), pulse is 87/min, and blood pressure is 98/62 mm Hg. Examination shows swelling and tenderness of the left ankle and knee; range of motion is limited. Lungs are clear to auscultation. A grade 3/6 holosystolic murmur is heard best at the apex. Abdominal examination shows no abnormalities. Antistreptolysin O titers are 400 Todd units/mL (normal: <300 Todd units/mL).  The patient is admitted to the hospital.  During her hospitalization, this patient is at greatest risk of dying from which of the following complications?

Quizplus · Accepted Answer

Eductional Objective: The primary cause of morbidity in acute rheumatic fever is heart failure from severe pancarditis.  Mitral stenosis develops years or decades after the original illness.  Joint involvement is usually transient.

A 12-Year-Old Girl Is Brought to the Physician by Her