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File:IPLab9ARF6.jpg|This high-power photomicrograph of myocardium shows the cellular detail of another Aschoff body. In this case there appears to be a multinucleated Aschoff giant cell (arrow).
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== Study Questions ==
* <spoiler text="What is the etiology of rheumatic myocarditis?">Rheumatic fever is an acute, often recurrent, inflammatory disease that principally affects children following a pharyngeal (but not skin) infection with group A beta-hemolytic streptococci. Evidence strongly suggests that rheumatic fever is the result of an immune response to streptococcal antigens inciting either a cross-reaction to tissue antigens or a streptococcal-induced autoimmune reaction to normal tissue antigens.</spoiler>
* <spoiler text="Would it be possible to culture the causative agent from these lesions on the heart valves?">No. Rheumatic fever is an immune-mediated disease. No organisms can be cultured from the heart valves or from the Aschoff bodies.</spoiler>
* <spoiler text="Is this case an example of acute rheumatic fever?">Yes and no!
This patient has acute ramifications of rheumatic fever (acute valve lesions and Aschoff bodies) but there are also a number of old lesions in the heart suggesting that this patient has had numerous bouts of rheumatic fever over the course of many years.</spoiler>
{{IPLab 9}}
[[Category: IPLab:Lab 9]]
