A 37-year-old diabetic, male visits his family physician because his joints have recently become achy. A month ago, he had a bad sore throat. Treatment was not sought at that time. Physical examination reveals he is febrile (100°F) and has a heart murmur which was not evident in the past. No signs of a throat infection are seen, and a rapid strep test was negative. A throat culture was taken. His skin appears normal.

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