The differential diagnosis of rheumatic fever still remains one of the major problems in pediatric practice, since there are many diseases which simulate its symptoms. One of the less well-recognized of these diseases is familial Mediterranean fever (F.M.F.)1 which appears to be part of the group of conditions designated as "periodic," and one which occurs primarily in people originating in the Mediterranean basin. In most cases the differentiation between rheumatic fever and F.M.F. is not too difficult despite the similarity in symptoms, the most important of which are: fever, abdominal pains, arthralgia or even frank arthritis, and a very rapid sedimentation rate. The most important difference between the two diseases is that in F.M.F. one does not, as a rule, find the cardiac murmurs so typical of rheumatic carditis.
In this paper we wish to report a case of F.M.F. which is unusual because of the presence of prominent