Acute rheumatic fever (ARF) is an inflammatory disease of childhood that occurs following untreated group A streptococcal pharyngeal infections. Although it is well established that group A streptococcus is the sole etiologic agent of ARF, the pathogenesis and immune mechanisms are still not completely understood. In the pediatric population, ARF is the most common cause of acquired heart disease worldwide. This multi-systemic disorder can affect the heart, joints, skin and with the exception of the central nervous system, usually develops within 3 weeks after the preceding acute group A...