The goals of treatment for rheumatic fever are to destroy any remaining group A streptococcal bacteria, relieve symptoms, control inflammation and prevent recurring episodes of rheumatic fever.
Treatments used for rheumatic fever include:
Antibiotics. Your child's doctor will prescribe penicillin or another antibiotic to eliminate any remaining strep bacteria that may exist in your child's body.
After your child has completed the full antibiotic treatment, your doctor will begin another course of antibiotics to prevent recurrence of rheumatic fever. This preventive treatment usually continues until your child is at least 21 years old. If an older teenager has had rheumatic fever, he or she may continue taking the antibiotics past age 20 to complete a minimum five-year course of preventive treatment.
People who experienced inflammation of the heart when they had rheumatic fever may be advised to take the preventive antibiotic treatment much longer or even for life.
- Anti-inflammatory treatment. Your doctor will prescribe a pain reliever, such as aspirin or naproxen (Anaprox, Naprosyn, others), to reduce inflammation, fever and pain. If symptoms are severe or your child isn't responding to the anti-inflammatory drugs, your doctor may prescribe a corticosteroid, such as prednisone.
- Anticonvulsant medications. If the involuntary movements of Sydenham chorea are severe, your doctor may prescribe an anticonvulsant, such as valproic acid (Depakene) or carbamazepine (Carbatrol, Equetro, others).
Discuss with your doctor what type of follow-up and long-term care your child will need. Heart damage from rheumatic fever may not show up until many years after the acute illness. Your child should be informed that he or she had rheumatic fever and when an adult should discuss this with his or her doctor.
Feb. 18, 2014
- Bonow RO, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0398-6..C2009-0-59734-6--TOP&isbn=978-1-4377-0398-6&about=true&uniqId=236798031-10. Accessed Aug. 12, 2013.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Aug. 12, 2013.
- Rheumatic fever. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/pediatrics/rheumatic_fever/rheumatic_fever.html. Accessed Aug. 12, 2013.
- Marijon E, et al. Rheumatic heart disease. The Lancet. 2012;379:953.
- Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed Aug. 12, 2013.
- Chow AW, et al. Evaluation of acute pharyngitis in adults. http://www.uptodate.com/home. Accessed Aug. 12, 2013.
- Gibofsky A, et al. Epidemiology and pathogenesis of acute rheumatic fever. http://www.uptodate.com/home. Accessed Aug. 12, 2013.
- Schmitt BD. Pediatric Telephone Protocols. 13th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2011:1.
- Mankad R (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 4, 2013.