All are true about rheumatic fever, EXCEPT :
**Core Concept**
Rheumatic fever is an autoimmune inflammatory disease that occurs after a group A beta-hemolytic streptococcal (GABHS) infection, typically pharyngitis. The disease process involves molecular mimicry between the streptococcal antigens and host cardiac tissues, leading to an autoimmune response.
**Why the Correct Answer is Right**
The correct answer is the option that does not accurately describe rheumatic fever. This disease is characterized by:
* **Carditis**: Inflammation of the heart, which can lead to valve damage and heart failure.
* **Arthritis**: Joint inflammation, particularly affecting the large joints.
* **Sydenham's chorea**: A neurologic disorder characterized by involuntary movements.
* **Erythema marginatum**: A skin rash.
* **Subcutaneous nodules**: Small, painless nodules under the skin.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not a characteristic of rheumatic fever.
**Option B:** This option is not a characteristic of rheumatic fever.
**Option C:** This option is not a characteristic of rheumatic fever.
**Clinical Pearl / High-Yield Fact**
Rheumatic fever is a preventable disease through timely administration of antibiotics for streptococcal pharyngitis. The Jones criteria are used to diagnose rheumatic fever, which include major and minor criteria.
**Correct Answer:** D