Rheumatic Fever Is Caused by ________

Multiple Choice

Rheumatic fever is caused by ________.

A) a primary streptococcal infection with Streptococcus pyogenes
B) a combination of infection with Streptococcus pyogenes and the rheumatic fever virus
C) a secondary streptococcal infection with a different type of streptococcus
D) an immunological cross-reaction in which anti-streptococcal antibodies target the heart
E) both a primary viral infection and a secondary streptococcal infection