Which of the following is considered to be a nonsuppurative complication of streptococcal infection?

• A. Acute rheumatic fever
• B. Scarlet fever
• C. Impetigo
• D. Pharyngitis

Answer: (A)

The main idea is recognizing immune-mediated, nonsuppurative sequelae that can follow a streptococcal infection rather than the direct infection itself or a toxin effect. Acute rheumatic fever fits this best because it’s an autoimmune response triggered by a streptococcal infection, weeks after the illness, that causes inflammation in the heart, joints, and sometimes the nervous system. It occurs without pus formation, distinguishing it from suppurative infections.

Scarlet fever is a toxin-driven manifestation that accompanies the infection rather than representing a post-infectious complication. Impetigo is a localized pus-producing skin infection, which is a purulent process, not a nonsuppurative complication. Pharyngitis is the active throat infection itself, not a complication.

So, acute rheumatic fever is the classic nonsuppurative, immune-mediated complication of streptococcal infection.