A Case of Rheumatic Fever that was Diagnosed Following Sydenham’s Chorea

Abstract

The patient was 12-year-old girl, who was admitted to our hospital with gait disturbance and involuntary movements that had appeared 7 days prior. Laboratory tests revealed elevated levels of serum anti-streptolysin O and anti-streptokinase titers. Doppler Color Echocardiography also showed mild mitral and tricuspid regurgitation. The patient exhibited the following required criteria: two major diagnostic criteria of Sydenham chorea and subclinical carditis; one minor diagnostic criteria of arthralgia. The Jones Criteria for Diagnosis of Rheumatic Fever was fulfilled after admission. Recently rheumatic fever has been decreasing rapidly in well-developed countries. It is believed that there may be many undiagnosed cases because the diagnostic criteria are unfulfilled when the symptoms of Sydenham’s chorea appear. We propose that it is necessary to consider rheumatic fever with carditis in the presence of Sydenham’s chorea.