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Cardiovascular 3

A 10-year-old boy is brought to the office with a chief complaint of whole body aches and stomach pain that have progressively been getting worse over the past three days. He reports a sore throat which has made it difficult to swallow. His past medical history includes a few cases of the common cold and an ear infection. He had previously been seen at another clinic a month ago for his sore throat which was diagnosed as a viral infection and thus went untreated. He is not currently on any medications. His temperature is currently 102°F (38.8°C) with a heart rate of 125 beats/minute. Physical examination shows a normal pharynx. On cardiac auscultation, a murmur is heard over the mitral valve area as well as a friction rub. He is admitted to the inpatient setting for further assessment. An echocardiogram shows pericarditis but no other structural abnormalities. His blood work shows increased white blood cell count, elevated C-reactive protein (CRP), and elevated erythrocyte sedimentation rate (ESR). He is started on long-acting intramuscular penicillin G benzathine to treat the suspected causative agent.

Secondary prophylaxis with antibiotics is used to decrease the risk of which of the following complications?

  • A) Erythema marginatum
  • B) Migratory arthritis
  • C) Pneumonia
  • D) Rheumatic heart disease
  • E) Sydenham chorea


Robert Li


Dr. Ted O'Connell

Last updated

Jun 07, 2022

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