A child with a history of rheumatic fever recently had arthritis but no cardiac involvement. Which statement describes ongoing care?

A child with a history of rheumatic fever recently had arthritis but no cardiac involvement. Which statement describes ongoing care?

• A. Aspirin is given for 2 weeks and then tapered to discontinue the medication.
• B. Prophylactic amoxicillin will need to be given for 5 years.
• C. Steroids will be necessary to prevent development of heart disease.
• D. The child will need complete bedrest until all symptoms subside.

Answer: (B)

After an attack of rheumatic fever, preventing another episode is crucial because recurrences raise the risk of developing rheumatic heart disease later, even if the heart showed no involvement the first time. The best ongoing care is to provide long-term antibiotic prophylaxis to suppress strep infections and avert relapse. For a child who had rheumatic fever with arthritis but no cardiac involvement, the recommended duration of secondary prophylaxis is about five years (or until age 21, whichever is longer in some guidelines), and a penicillin-based regimen is used regularly—often given as an injectable penicillin or an oral penicillin/amoxicillin course. This approach targets the underlying risk of repeated streptococcal exposure and protects the heart from future damage. Other measures, like aspirin, address symptoms of arthritis but do not prevent recurrence; steroids aren’t routinely needed to prevent heart disease; and bedrest isn’t required once acute symptoms improve.

After an attack of rheumatic fever, preventing another episode is crucial because recurrences raise the risk of developing rheumatic heart disease later, even if the heart showed no involvement the first time. The best ongoing care is to provide long-term antibiotic prophylaxis to suppress strep infections and avert relapse. For a child who had rheumatic fever with arthritis but no cardiac involvement, the recommended duration of secondary prophylaxis is about five years (or until age 21, whichever is longer in some guidelines), and a penicillin-based regimen is used regularly—often given as an injectable penicillin or an oral penicillin/amoxicillin course. This approach targets the underlying risk of repeated streptococcal exposure and protects the heart from future damage. Other measures, like aspirin, address symptoms of arthritis but do not prevent recurrence; steroids aren’t routinely needed to prevent heart disease; and bedrest isn’t required once acute symptoms improve.