A 13-year-old boy has had a sore throat for at least a week and has been vomiting for 2 days. His glands are swollen, and he moves stiffly because his joints hurt. His parents, who believe in "natural remedies," have been treating him with various herbal preparations without success and are now seeking antibiotic treatment. Throat cultures show infection with group A streptococci. This child is at high risk for

Question

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Group A streptococcal infection can be adequately treated with antibiotics, but this infection may have been present long enough to trigger an immune response- rheumatic fever-that will damage his heart valves, ultimately causing mitralvalve stenosis. Group A streptococcal infection is not known to predispose to myocarditis, endocarditis, or vasculitis and aneurysm of coronary arteries.

A 13-Year-Old Boy Has Had a Sore Throat for at Least