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A 6 year old child comes to the clinic with 2 day history of fever, acute abdominal pain, and mild joint swelling. The child’s mom states that he had some type of sore throat recently and was treated successfully with some antibiotics. Upon physical exam, the patient had a temperature of 102 F with a new onset heart murmur. There was no evidence of joint edema, warmth, erythema, or tenderness at the time of the visit. Of the following, what would you least likely see in this patient.
A. Leukocytosis with increased PMN
B. Normocytic, normochromic anemia
C. Increased erythrocyte sedimentation rate
D. Positive throat culture for Streptococcus
E. Elevated serum titer of antistreptolysin O

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