Rheumatic Fever (cont.)
How is rheumatic fever treated?
The first step in treating rheumatic fever is to eradicate the bacteria which initially
caused the immunologic response. This is usually accomplished with the use of
penicillin. For penicillin-allergic patients, there are other options such as
erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) or azithromycin (Zithromax, Zmax). It is important to make sure that the acute
infection is treated, but such treatment won't necessarily change the course of
rheumatic fever once the immunologic response has begun.. Your doctor will
decide on the best treatment option for you. The joint pains are treated with
aspirin or aspirin-related medications. It may be necessary to use very high
doses to decrease the symptoms.
Carditis is treated by high-dose steroids but other cardiac medications may be
needed to control the inflammation of the heart. This is a serious condition and
is most often initially managed in an acute-care setting such as a hospital.
The most difficult and unpredictable symptom to treat is the chorea
(involuntary movements). It often responds to antipsychotic medications such as
haloperidol (Haldol) but may continue for a protracted period. For patients who
develop Sydenham's chorea, it can be the most difficult of the symptoms, since
it involves involuntary movements and can interfere with daily activities. These
individuals must remain on chronic long-term antibiotics to prevent recurrence
of the strep infection, which has been known to cause recurrence of the chorea.
What are the complications of
rheumatic fever?
Most significant of the complications are cardiac in nature. Patients with
rheumatic fever
who develop carditis may develop long-lasting heart dysfunction. Often the
mitral valve or the aortic valve is affected, and if patients are not responsive
to medications, surgical valve replacement may become necessary. Atrial
fibrillation (irregular fast heart rate) and heart failure can occur. Sydenham's
chorea can be the most difficult complication to treat, and the individuals with
this complication may get recurrence of the disease. A few people remain very
susceptible to reinfection with GABHS and may require lifetime antibiotic
treatment.
Next: How is rheumatic fever prevented? »
- azithromycin, Zithromax, Zmax - Establishes the medication azithromycin (Zithromax), a drug that is effective against susceptible bacteria causing infections, and certain sexually transmitted infectious diseases.
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- Strep Throat - Learn about strep throat symptoms like fever, nasal drainage, sore throat, swollen glands, difficulty swallowing, irritability. Causes and treatments are discussed in the information.
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