In considering the etiology of Sydenham's chorea, the majority of observers are of the opinion that all such chorea is of rheumatic origin. This opinion is based largely on the fact that there is frequent involvement of the heart. Yet in all other respects, chorea differs from the clinical picture of rheumatism as seen in childhood. One is inclined to wonder, therefore, whether some of the cases of ordinary chorea in childhood are caused by another virus than that of rheumatism. In reviewing the histories of a large number of cases of chorea one sees numerous instances in which chorea is the only manifestation of disease, unattended by arthritic symptoms or other evidences of rheumatic infection. In apparent contrast to these instances are the many cases of chorea which either follow or precede a typical attack of rheumatic fever with cardiac involvement, or in which successive attacks of rheumatic fever
SCHWARZ H, LEADER SD. LATENT CARDIAC COMPLICATIONS FOLLOWING SYDENHAM'S CHOREA. Am J Dis Child. 1935;49(4):952–957. doi:10.1001/archpedi.1935.01970040120015
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