Syndenham Chorea and Incidious Carditis in A 9 Years Old

SYDENHAM’S CHOREA AND INSIDIOUS CARDITIS IN A - 9 YEAR OLD GIRL Putu Ayu Widyanti, Eka Gunawijaya, Dewi Sutriani Department of Child Health, Medical School, Udayana University/ Sanglah Hospital, Denpasar Abstract Sydenham’s chorea is the most common form of acquired childhood chorea, and represent one of the major diagnostic criteria of rheumatic fever. It characterized by involuntary movements which disappear during sleep, emotional instability, and hypotonia. We presented a - 9 year old girl with choreatic movement (involuntary movement of arm and feet). The unwanted movement also found on tounge made difficult to speak. She also had emotional lability, and muscle weakness.The history of trauma was denial. On physical examination found murmur at apex area, holosistolic, grade 2/6, blowing, and spreading along axilla. On echocardiography found moderate mitral regurgitation (MR) and trivial aortic regurgitation (AR) due to carditis. The diagnosis was sydenham’s chorea and carditis. She was treated with erythomicin 250 mg four times a day for 10 full days, and followed by erythromycin 250 mg orally twice a day for prophylaxis. For symptomatic treatment, haloperidol 2 mg twice a day and trihexyphenidil 0.5 mg three times a day was given. The therapy respon and prognosis was good. (MEDICINA 2012;43:54-59). Keywords: Sydenham’s chorea, rheumatic fever, carditis