Shakya, KNBhatta, AYadav, AGautam, UBasnet, S2025-12-142025-12-142021https://hdl.handle.net/20.500.14572/3629Shakya KN, Bhatta A, Yadav A, Gautam U, Basnet S Department of Pediatrics Kathmandu Medical College, Sinamangal, Kathmandu, NepalABSTRACT Sydenham’s chorea is an uncommon neurological manifestation of rheumatic fever and has many and varied differential diagnosis. It may mimic encephalitis when presents as an isolated feature even when silent cardiac lesions are present. Early diagnosis, treatment and penicillin prophylaxis prevents recurrence and progression of cardiac lesions. Prompt symptomatic relief and alleviation of distress is obtained with therapeutic intervention. A case of rheumatic chorea with silent cardiac valve lesions which mimicked herpes simplex encephalitis with choreoathetosis, in a 13 year old girl is presented along with review of literature. KEY WORDS Chorea, Encephalitis, Rheumatic fever, Silent carditisen-USChoreaEncephalitisRheumatic feverSilent carditisArticle