A 16-year-old boy was presented with abnormal involuntary facial movements for the last 24 hours. He denies weakness or sensory loss. Patient history He was well unit 8 weeks before a presentation when he developed a sore throat and fever, associated with pain and swelling in several large joints. The symptoms began in his knees, then moved to his ankles, elbows. His pain subsided only partially by ibuprofen. However, he made full recovery within 3 weeks. Examination This boy is well and not febrile now.
His brief uncoordinated facial movements are consistent with chorea. Skin, nails, and mucosal surfaces appear normal. Cardiovascular examination reveals a friction rub and pansystolic murmur in the mitral area. Respiratory and abdominal examinations are normal. There is cool effusion in his left elbow. What is the most likely diagnosis? *This case is from Docplexus editorial team for…
