Which of the following is not included in Jone’s Major Criteria
**Core Concept**
Jones criteria are used to diagnose Acute Rheumatic Fever (ARF), a complication of untreated or inadequately treated group A beta-hemolytic streptococcal (GABHS) pharyngitis. The criteria are divided into major and minor criteria, with the major criteria being more specific but less sensitive.
**Why the Correct Answer is Right**
The Jones major criteria include carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules. These criteria are highly specific for ARF and are used to confirm the diagnosis when two or more major criteria are present. The presence of the major criteria indicates a high likelihood of ARF, particularly when accompanied by evidence of recent GABHS infection.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because it is not a recognized major criterion for ARF. While fever can be a symptom of ARF, it is not a specific criterion used to diagnose the condition.
* **Option B:** This option is incorrect because it is not a major criterion for ARF. While elevated ESR and CRP can be associated with ARF, they are not specific criteria used to diagnose the condition.
* **Option C:** This option is incorrect because it is not a major criterion for ARF. While tachycardia can be a symptom of ARF, it is not a specific criterion used to diagnose the condition.
**Clinical Pearl / High-Yield Fact**
Remember that the Jones major criteria are highly specific for ARF, but the minor criteria are more sensitive and can be used to identify patients who may be at risk for developing ARF.
**Correct Answer: A. Fever**