RT Journal Article SR Electronic T1 Lessons of the month: Reemergence of rheumatic fever after a systemic streptococcal A infection: The role of cardiac MRI on the diagnosis of subclinical rheumatic carditis JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP e206 OP e208 DO 10.7861/clinmed.2020-0163 VO 20 IS 5 A1 John Serelis A1 Nikolaos Alexopoulos A1 Fotini N Skopouli A1 Haralampos M Moutsopoulos YR 2020 UL http://www.rcpjournals.org/content/20/5/e206.abstract AB A 42-year-old man presented with fever, sore throat, rash and painful right knee swelling, preceded by self-medication with oral steroids. Blood and knee cultures yielded group A Streptococcus. After 2 weeks of intravenous antibiotics and two arthroscopic knee debridements, he continued to experience spiking fevers, and electrocardiographic changes developed. We postulate that the patient suffered from the first presentation of acute rheumatic fever, following an invasive group A bacteraemic streptococcal infection. The possible role of cardiac magnetic resonance imaging in the diagnosis of rheumatic carditis is discussed.