Sydenham's chorea in a 16‐year‐old female from Bhutan: A case report

Key Clinical Message Rheumatic heart disease is a preventable disease. Patients may not present with a typical history of sore throat and polyarthritis but may present with Sydenham's chorea. We should not rely completely on clinical findings to rule out carditis. Echocardiography should be don...

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Bibliographic Details
Published in:Clinical case reports 2024-07, Vol.12 (7), p.e9047-n/a
Main Authors: Penjor, Tshering, Dorji, Thinley, Wangchuk, Sangay
Format: Article
Language:English
Subjects:
acute rheumatic fever
Arthritis
Auscultation
Cardiovascular disease
Case Report
Case reports
diagnostic criteria
Ejection fraction
Electrocardiography
Erythema
Females
General Medicine
Heart
Infections
Mental disorders
Patients
Rheumatic fever
rheumatic heart disease
Sinuses
subclinical carditis
Sydenham's chorea
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Summary:Key Clinical Message Rheumatic heart disease is a preventable disease. Patients may not present with a typical history of sore throat and polyarthritis but may present with Sydenham's chorea. We should not rely completely on clinical findings to rule out carditis. Echocardiography should be done to rule out subclinical carditis. Sydenham's chorea is a major manifestation of rheumatic fever. It occurs primarily in children and is seen rarely after the age of 20 years. We describe a 16‐year‐old girl who presented with purposeless involuntary movements of her upper and lower limbs. Laboratory blood reports showed raised erythrocyte sedimentation rate and anti‐streptolysin O. 2D Doppler Echocardiography confirmed subclinical carditis, thickened mitral and aortic valve with mild mitral regurgitation. She was managed as Acute Rheumatic Fever with oral Phenoxymethyl penicillin and Carbamazepine. At the latest follow‐up interviewing the caregiver, the patient had no sequelae. Early diagnosis is key to preventing late consequences of acute rheumatic fever and rheumatic heart disease. Sydenham's chorea is a rare presentation of acute rheumatic fever. The absence of clinical carditis does not rule out carditis.
ISSN:2050-0904
2050-0904
DOI:10.1002/ccr3.9047