[Chorea subsequent to acute rheumatic fever in a 9-year-old girl]

A nine-year-old girl had acute choreatic symptoms in her face and limbs, after a throat infection 6 weeks previously. On auscultation of the heart a systolic murmur was found and echocardiography showed mitral valve incompetence. There was a positive anti-deoxyribonuclease B titre in the serum, providing evidence of a previously contracted streptococcal infection. Both chorea and acquired carditis are major criteria for the diagnosis of acute rheumatic fever. The course was characterized--as it usually is--by spontaneous, gradual resolution of the symptoms. Protracted penicillin prophylaxis is indicated to prevent recurrence of acute rheumatic fever and cardiac valvular damage.