Sydenham chorea (SC) is the neurological manifestation of rheumatic fever and is the most common acquired chorea in children. The disease presents as choreiform movements and behavioral changes after a streptoccocal throat infection. Although the incidence of SC has diminished because of aggressive antibiotic treatment, both isolated cases and epidemics persist, necessitating emergency physicians to be familiar with the disease. We describe the case of a 9-year-old girl with SC. A discussion of the pathophysiology, clinical presentation, and management of SC in the emergency department follows.
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