Rheumatic Fever And Its Management

Rheumatic Fever And Its Management

Question. Outline the management of acute rheumatic fever.
Or
Discuss the management of acute rheumatic fever.

Answer.

Management of Acute Rheumatic Fever.

1. Treatment of acute attack: Rheumatic Fever

1. Bed rest is important to reduce joint pain and cardiac workload.
   Duration of bed rest is guided by markers of inflammation, like temperature,
   WBC count and ESR.
2. Benzathine penicillin 1.2 mu IM 4 hourly. If the patient is allergic to penicillin, erythromycin 40–50 mg/kg for ten days is given.
3. Aspirin usually relieves symptoms of arthritis rapidly.
   A 60 mg/kg body weight starting dose per day is given, divided into 6 doses.
   The dose may be increased to 120 mg/kg body weight.
   This dose may produce severe symptoms like vomiting, tachypnea, and acidosis. Aspirin is given till ESR comes to normal.
4. Corticosteroids like prednisolone produce rapid symptomatic relief than aspirin and are indicated in cases with severe arthritis or carditis.
   Prednisolone is given in doses of 1.2 mg/kg body weight till ESR comes to normal

Rheumatic Fever and Its Management

2. Secondary prevention: Rheumatic Fever

Long-term prophylaxis is needed to prevent further attacks of rheumatic fever.

Management of Rheumatic Fever

1. Benzathine penicillin 1.2 mu IM is injected at an interval of 21 days.
   Further attacks are unusual after the age of 21 years, and treatment can be stopped.
2. To prevent the chances of endocarditis, prophylactic antibiotic therapy should be given.