Sx: SOB, nose bleeds, vomiting, rash, pain in stomach and joints.
Patho: throat culture done to see if she was positive for the group A beta-hemolytic streptococci. Antibodies directed against the M proteins of the streptococci cross reacts with tissue glycoproteins in the heart, joints, CNS, and skin. It causes an abnormal humoral and cell-mediated immune response and the antigens can bind to receptors on cells in the heart, muscle, brain, and synovial joints. Inflammatory lesions will develop in the connective tissues. Overall heart valves will be damaged.