TABLE 60.4 DISTINGUISHING CLINICAL FEATURES OF ETIOLOGIES OF POLYARTHRITIS Disease Clinical characteristics Gonococcal Lyme Acute rheumatic fever Serum sickness Kawasaki disease Subacute bacterial endocarditis Systemic lupus erythematosus Henoch–Schönlein purpura Inflammatory bowel disease Adolescent, tenosynovitis, rash Tick bite, erythema migrans, endemic region, seasonality Recent streptococcal infection, extreme migratory pain, carditis Urticaria, angioedema Prolonged fever, rash, conjunctivitis, mouth changes Congenital heart disease, fever, new murmur, splinter hemorrhages African-American female, skin or renal disease Purpura below the waist, nephritis, abdominal pain, scrotal swelling Abdominal pain, diarrhea, weight loss, anemia