Early lesions have a central zone of ulceration covered by a fibrinous membrane. Chronic rheumatic heart disease is characterized by repeated inflammation with fibrinous resolution. The pericardium is infiltrated by the fibrinous exudate. The bacterium causes severe inflammation of the epididymis, with formation of spermatocoeles and fibrinous adhesions. Chronic rheumatic heart disease (RHD) is characterized by repeated inflammation with fibrinous repair. Obstruction/occlusion of EVD commonly due to fibrinous/clot like material or kinking of the tube. A fibrinous pericarditis can develop with a classic friction rub that can be auscultated.