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Sydenham chorea — RACP Paediatrics MCQ

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HardNeurologySydenham choreaRACP Paediatrics

A 9-year-old Aboriginal child in a remote community has fever and sore throat without viral features. The community has a high incidence of acute rheumatic fever. Rapid testing is unavailable. What is the appropriate antibiotic approach?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Give empirical group A streptococcal treatment under the high-risk pathway

Explanation lettering: D = shown as B · E = shown as C · C = shown as D · B = shown as E

D is correct because Australian guidance treats sore throat empirically in recognised high-risk groups, irrespective of the usual imperfect clinical discrimination, to reduce acute rheumatic fever risk. E applies the low-risk pathway and may miss the prevention window. A makes rash an unnecessary condition. B contradicts Australian epidemiology. C ignores penicillin as preferred therapy and antimicrobial stewardship unless allergy or another indication changes selection.

Reference: Royal Children’s Hospital Melbourne, Sore throat: https://www.rch.org.au/clinicalguide/guideline_index/sore_throat/