children s health issues
Rheumatic Fever
Treatment of Rheumatic Fever
Antibiotics Aspirin Sometimes corticosteroids Treatment of rheumatic fever has three goals: Eliminating any remaining streptococcal infection Reducing inflammation, particularly in the joints and heart, and thus relieving symptoms Preventing future infections Doctors give children with rheumatic fever antibiotics to eliminate any remaining infection. A long-acting penicillin is given as a single injection or penicillin oramoxicillinis given by mouth for 10 days. Aspirinis given in high doses for several weeks to reduce inflammation and pain, particularly if inflammation has reached the joints and heart. Some other nonsteroidal anti-inflammatory drugs (NSAIDs), such asnaproxen, may be as effective asaspirin, but, in most children,aspirinis preferred for the treatment of rheumatic fever. If heart inflammation is severe, corticosteroids such asprednisoneare recommended in addition toaspirinand may be given by vein (intravenously) or by mouth to further reduce inflammation. Children should limit their activities if they have joint pain, chorea, or heart failure. Children who do not have inflammation of the heart do not need to limit their activities after the illness subsides. Prolonged bed rest is not helpful. The best way to prevent rheumatic fever is with prompt and complete antibiotic treatment of any streptococcal throat infection. In addition, children who have had rheumatic fever should be given drugs (typically penicillin) by mouth every day or by monthly injections into the muscle to help prevent another streptococcal infection. When antibiotics are given to people who do not yet have an infection, this preventive treatment is called prophylaxis. How long this preventive treatment should be continued is unclear. It depends on the severity of the disease and is usually continued for at least 5 years or until age 21 (whichever is longer). Some doctors recommend that it should be continued for life in certain people, such as those who have lasting heart valve damage and have close contact with young children (because the children may carry streptococcal bacteria, which could reinfect such people). 