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Rheumatic Fever Prophylaxis

Rheumatic fever prophylaxis

What is rheumatic fever prophylaxis?

Rheumatic fever prophylaxis refers to the practice of giving antibiotics to a person with acute streptococcal pharyngitis (a Strep throat infection) to prevent an attack of rheumatic fever. Rheumatic fever is an inflammatory condition that can affect the whole body as well as cause permanent damage to the heart. It is a reaction to an untreated streptococcal throat infection.

What causes rheumatic fever?

Rheumatic fever may occur following an untreated Strep throat infection caused by the Streptococcal pyrogenes bacteria.

Although it occurs following an infection, it is not an infection. Rather it is an inflammatory reaction caused by the bacteria tricking the body’s immune system into attacking healthy tissue.

Rheumatic fever more commonly occurs in children, between the ages of 5 and 15. Although rare in the contiguous U.S., (children with a Strep throat have only a 1-3% chance of developing rheumatic fever if they live in the U.S.) the disease is still prevalent in children of Samoan descent living in Hawaii and residents of American Samoa. It is much more common in developing countries or in people who live in overcrowded living conditions, with poor nutrition, or with lower social and economic status.

The tendency to develop rheumatic fever appears to run in families. Children who have had rheumatic fever in the past have a 50% chance of developing it again following another Strep throat infection.

What are the symptoms of rheumatic fever?

Symptoms of rheumatic fever usually appear 14 to 28 days after a S. pyrogenes infection and the condition mainly affects the heart, joints, skin, and the brain.

Symptoms of rheumatic fever include:

  • Fever
  • Abdominal pain
  • Chest pain or shortness of breath
  • Joint swelling, pain, redness, or warmth
  • Nose bleeds
  • A rash on the upper part of the arms or legs (usually ring-shaped or snake-like)
  • Skin nodules or lumps
  • Unusual crying or laughing or quick jerky movements of the face, hands, or feet.

How do you administer rheumatic fever prophylaxis?

Antibiotics are given as rheumatic fever prophylaxis and these are effective at preventing rheumatic fever if administered promptly or within nine days of symptoms. Most people with rheumatic fever recover; however, in a small percentage of people the heart is permanently damaged.

Antibiotics that may be given as rheumatic fever prophylaxis include:

  • Penicillin
  • Erythromycin
  • Sulfadiazine.

The antibiotic course must be completed as prescribed by your doctor. If the condition develops in children before antibiotics can be administered, regular penicillin injections are usually needed until the age of 21 or for 10 years after diagnosis.

Pain relievers may also be given to alleviate pain or corticosteroids given to reduce inflammation.