Which is NOT a major clinical feature of acute rheumatic fever?

Acute rheumatic fever is a complex inflammatory disease that can occur after a streptococcal throat infection. The significant clinical features of this condition are based on the Jones criteria, which include carditis, erythema marginatum, and Sydenham chorea, among others.

Carditis refers to the inflammation of the heart, which can manifest as myocarditis, endocarditis, or pericarditis, presenting clinically with symptoms such as heart murmurs and signs of heart failure. Erythema marginatum is a specific type of rash characterized by pink rings on the trunk and inner surfaces of the limbs. Sydenham chorea is a neurological manifestation that includes involuntary movements, typically seen in children and develops weeks to months after the initial infection.

While fever can accompany many infectious and inflammatory processes and might be present in cases of acute rheumatic fever, it is not considered a major distinguishing feature of the disease itself. Fever is quite nonspecific and can arise from various causes; thus, it does not fulfill the criteria used to diagnose acute rheumatic fever when compared to the more definitive features listed above. Therefore, among the listed options, fever is the one that does not constitute a major clinical feature of acute rheumatic