Case Study: A 9-year old boy complains of pain and swelling in his left ankle for 5 days. Over the last 2 days he also f

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Case Study: A 9-year old boy complains of pain and
swelling in his left ankle for 5 days. Over the last 2 days he also
feels increasing pain in his right knee. Joint fluid was taken and
found to be sterile, excluding septic arthritis. A murmur was
noticed during examination of the heart. His blood cultures were
negative. Four weeks earlier, the boy had a sore throat and
tonsillitis, caused by Streptococcus pyogenes [Group A
streptococcus] but he didn’t receive any medical treatment at the
time.
What is causing the symptoms (heart murmur, painful
joints)? (25%)
What immediate and long-term treatment would you suggest
and why? (15%)
Briefly describe how penicillin works.
(25%)