A 12 year old girl was brought with fever, malaise, and migrating polyahritis. She had a history of recurrent throat infections in the past. Elevated erythrocyte sedimentation rate is noted. Which among the following is NOT a major Jones criteria for diagnosis of acute rheumatic fever?

Revised Jones Criteria for Diagnosis of Rheumatic Fever: Major criteria: Pericarditis, myocarditis, or endocarditis Chorea Subcutaneous nodules Erythema marginatum Polyahritis Minor criteria: Fever Ahralgias Laboratory findings: elevated sedimentation rate, evidence of preceding streptococcal infection (increased titer of antistreptolysn O), increased C-reactive protein History of rheumatic fever or rheumatic hea disease; increased PR interval on ECG The presence of two major or one major and two minor criteria with suppoing evidence of recent infection with group A streptococcus indicates a high probability of rheumatic fever. Ref: Woods R.P., Seamon J. (2011). Chapter 21. Ahritis & Back Pain. In R.L. Humphries, C. Stone (Eds), CURRENT Diagnosis & Treatment Emergency Medicine, 7e.