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Investigations revealed pericardial and pleural effusions, pericardial thickening on MRI, mild mitral regurgitation on echocardiogram and a raised Antistreptolysin O (ASO) titre.<\/jats:p>\n               <jats:p>He was treated as acute rheumatic fever (ARF) with a prolonged course of penicillin, supportive therapy with bisoprolol and colchicine with lansoprazole cover. The patient made a full recovery and subsequent cardiac MRI showed resolution of all changes.<\/jats:p>","DOI":"10.1136\/bcr-2021-244469","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T11:26:10Z","timestamp":1636457170000},"page":"e244469","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Suspected acute rheumatic fever in a young man in England"],"prefix":"10.1136","volume":"14","author":[{"given":"Zak Michael","family":"Wilson","sequence":"first","affiliation":[{"name":"Acute Medicine, Royal Devon and Exeter Hospital, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Craster","sequence":"additional","affiliation":[{"name":"Acute Medicine, Royal Devon and Exeter Hospital, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"2025082709073575000_14.11.e244469.1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/S0140-6736(05)66874-2","article-title":"Acute rheumatic fever","volume":"366","author":"Carapetis","year":"2005","journal-title":"The Lancet"},{"key":"2025082709073575000_14.11.e244469.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h3443"},{"key":"2025082709073575000_14.11.e244469.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.792135"},{"key":"2025082709073575000_14.11.e244469.4","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1093\/infdis\/jix637","article-title":"Group G Streptococcus induces an autoimmune carditis mediated by interleukin 17A and interferon \u03b3 in the Lewis rat model of rheumatic heart disease","volume":"218","author":"Sikder","year":"2018","journal-title":"J Infect Dis"},{"key":"2025082709073575000_14.11.e244469.5","unstructured":"Webb R . 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UpToDate [Internet]. Uptodate.com, 2020. 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