Treatment. Rheumatic Fever

Treatment of rheumatic fever

Goals for treating rheumatic fever include the following:

• Destroying any of the group A strep bacteria that may still be present in the body
• Relieving the symptoms of rheumatic fever
• Decreasing the inflammation 
• Preventing further episodes of rheumatic fever

Medications for rheumatic fever treatment

• Antibiotics: In order to get rid of any strep bacteria that may still be present in the body, your physician will prescribe an antibiotic as treatment for rheumatic fever. When this course of medication is completed, another course of medication will be started to prevent rheumatic fever from returning. Most children need to continue these preventative antibiotics until they become adults. If your child is an adolescent or a teen when they develop rheumatic fever, they may have to continue the medications until they have taken it for a minimum of five years. If there is evidence of cardiac (heart) inflammation due to rheumatic fever, antibiotics may be recommended for an even longer period of time or for the rest of a person’s life.
• Anti-inflammatory treatment: A pain medication like ibuprofen or naproxen is usually recommended in addition to primary rheumatic fever treatment to help reduce inflammation, relieve pain, and control fever. Medications for severe cases of rheumatic fever include corticosteroids like prednisone.
• Anticonvulsant medications: Your physician may prescribe anticonvulsant medications for the rheumatic fever to help control the involuntary movements associated with the condition. Examples of these medications include valproic acid and carbamazepine. 

Long-term care

Follow-up care is usually decided on a case-by-case basis, so discuss with your physician what care will be needed for your child. In many cases, the heart damage caused by rheumatic fever does not become apparent until many years following the acute infection. Therefore, when your child becomes an adult, it will be vital that he or she knows they had rheumatic fever as a child so they can make their health care providers aware of this and discuss it with them.

Useful Advice

Bed rest is sometimes recommended for children who have been diagnosed with rheumatic fever. It is often best if these children’s activities are restricted to allow their bodies to heal from the inflammation and the pain and fever of rheumatic fever resolve. If heart inflammation is present, your physician may recommend that your child be placed on strict bed rest for a longer period of time, depending on the severity of inflammation.

Prevention

The only way doctors know of to prevent rheumatic fever from occurring is to treat scarlet fever and strep throat infections promptly and thoroughly with a complete course of appropriate antibiotic therapy.

Outcome & Complications

Rheumatic fever cause inflammation that can last over the course of a few weeks to a few months. Sometimes, the inflammation can cause long-term complications associated with the heart.

Permanent damage done to the heart caused by the inflammation of rheumatic fever is known as rheumatic heart disease. This complication most often causes problems with the valve located between the left chambers of the heart (the mitral valve), but it may also affect the other heart valves as well. Valve damage can cause the following conditions to occur:

• Valve stenosis: This is a narrowing in the valve which restricts the amount of blood flowing through the heart. 
• Valve regurgitation: In this condition, the valve leaks, causing blood to back up in the wrong direction. 
• Damage to the heart muscle: This is a weakening of the heart muscle itself caused by rheumatic fever, leading to decreased pumping action 

Any injury to the heart due to rheumatic fever can lead to problems with the function of the heart later in a person’s life. Problems that may result include:

• Heart failure: The heart cannot pump blood effectively enough to the body 
• Atrial fibrillation: The heart’s rhythm is irregular, resulting in the weakened pumping action