cardio rheumatic fever

Question 1

first line treatment of rheumatic fever

Answer 1

The first-line treatment is penicillin combined with symptomatic anti-inflammatory treatment, typically with salicylates or glucocorticoids (if salicylates are not effective).

First-line: penicillin V
In patients with penicillin allergy, use:
Cephalosporins (hypersensitivity without anaphylaxis)
OR macrolides (severe hypersensitivity to beta-lactam antibiotics)

Question 2

diagnostic criteria for rheumatic fever and interpretation

Answer 2

Initial episode of ARF: two major criteria or one major plus two minor criteria
Recurrent ARF: either the same as for an initial episode of ARF or the presence of three minor criteria

major: jones
minor:
Polyarthralgia
High fever (≥ 38.5ºC)
↑ Acute phase reactants (ESR ≥ 60 mm/hour and/or CRP ≥ 30 mg/L)
ECG showing prolonged PR interval