Tuesday, December 28, 2021

Rheumatic chorea - variable clinical presentation timelines

 Hello


Variations in clinical presentation of rheumatic/ sydenham's chorea -

a. 3-4 weeks after streptococcal pharyngitis, as a part of acute rheumatic fever (ARF) spectrum.

b. up to 6 months after other manifestations of ARF spectrum.

c. up to 6 months after streptococcal pharyngitis, with no other manifestations of ARF in between.


Note - In the clinical presentation c., when the patient may present with chorea up to 6 months after a streptococcal pharyngitis, an incidental finding on echocardiography may show a sub-clinical heart valves' involvement and fibrotic changes in myocardial tissue. This is an alarming situation and must start prophylactic antibiotics and other measures urgently so as to prevent onset of severe chronic RHD in future.


- Jaskunwar Singh

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