Rheumatic Fever - Pediatric Oncall

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
Hello, I am a 20 year old girl n i m suffered from rheumatic fever in may 2002. firstly I was treated with disprin. After 1 month I again had same problem then I was treated with penicillin 120000iu injections. Now for 3 years with interval of 23 days approximately I am given these penicillin 120000IU injections. I m suffering from DEMYELINATION as well since October 2002. I want to ask that for how long will I have 2 continue these injections. Are there some preventions for these, I mean some exercise or something like that. thank you.
Answer
Every patient of acute rheumatic fever is a candidate for continuous prophylaxis, as risk of recurrent attack of acute rheumatic fever continues. The method of choice is monthly intramuscular injection of 1.2 mega units of benzathine penicillin and at times every three weeks. In case of genuine penicillin allergy, sulfonamides (0.5gm/daily <25 kg and one gm daily above>25kg) or erythromycin can be used. The point of confusion is when to stop prophylaxis. If a patient presents with severe carditis or with recurrent episodes of Acute Rheumatic Fever, prophylaxis is considered for life. For moderate carditis, prophylaxis till 16 years and for mild or no carditis for 3 years from last episode should be given. Back to All Questions

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