A 34-year-old woman presents with a 2-day history of acute-onset involuntary jerking movements of the right arm and leg, along with facial droop, dysarthria, and dysphagia. She reports having pharyngitis 1 week prior, treated symptomatically. Vital signs are stable (BP 118/76 mmHg, HR 92 bpm, RR 16/min, Temp 37.2°C). Laboratory findings reveal ESR 62 mm/hr and elevated antistreptolysin O titer. Brain MRI shows no acute infarction or mass effect. Lumbar puncture demonstrates mild lymphocytic pleocytosis (18 cells/μL) with normal glucose and protein. Which of the following is the most likely diagnosis?
- A)Acute disseminated encephalomyelitis (ADEM)
- B)Acute ischemic stroke
- C)Bacterial meningitis
- D)Sydenham choreaGABARITO
- E)Anti-NMDA receptor encephalitis
Explicação
Sydenham chorea is a late neuropsychiatric manifestation of acute rheumatic fever (ARF) that typically occurs 2-3 weeks after group A Streptococcal pharyngitis. The classic triad includes involuntary choreiform movements (jerking of limbs), emotional lability,... Ver explicação completa e trilha adaptativa →