Sydenham chorea in a12- year old Saudi girl

Sydenham chorea (SC) is the most common acquired cause of chorea in children. (SC) is the neurological manifestation of rheumatic fever. Rheumatic fever is still reported in Saudi Arabia, although less frequently. According to modified Jones criteria, carditis and arthritis are the major manifestations of acute rheumatic fever (ARF) in children. SC is often seen in isolated form; however, it can occur in association with other clinical manifestations of ARF like carditis. It has been reported that silent, mild valvular regurgitation has been found in patients with pure chorea. SC is characterized by abnormal body movement, associated with behavioral changes. It is an autoimmune disease that occurs following an infection with Group A beta-haemolytic streptococcal infection that is prevalent in Saudi Arabia. Despite recent advances in child health care services, RF continues to occur in Saudi Arabia. We describe a 12-year-old Saudi girl with SC and clinically inaudible, but echocardiographically significant mild valvular regurgitation. The diagnosis of Sydenham chorea should be considered in young children with choreiform movements. Doppler echocardiography may be useful in detecting silent valvular regurgitation and in deciding the duration of penicillin prophylaxis.