Rheumatic Fever
Protocols
Clinical Features:
- 1)Fever.
- 2)Painful, tender joints (arthritis), most commonly in the knees, ankles, elbows, and wrists.(Large joint)
- 3)Symptoms of congestive heart failure, including chest pain, shortness of breath, fast heartbeat.
- 4)Fatigue.
- 5) Age 5 to 15 years
Past History:
- Sore throat 2-3 weeks back
investigation:
- 1)CBC-Leucocytosis with raised ESR
- 2)CRP-Raised
- 3)ASO TITER-raising titres
- 4)Throat swab culture 5)CXR-cardiomegaly,pulmonary congestion
- 6)ECG
- -2nd degree AV block
- -features pericarditis-T inversion
- 7)ECHO
- -Cardiac dilatation
- -valve abnormalities
Rx:
- complete bed rest
- diet-salt restriction
1.
if pt weight >27 kg
- inj.[post id="430" title="Benzathine-Penicillin"](Benzapen)(12lac/u) I/m single dose then prophylaxis monthly once
if pt weight < 27 kg
- inj.[post id="430" title="Benzathine-Penicillin"](Benzapen)(6 lac/u) I/m single dose then prophylaxis monthly once
OR
- Tab.[post id="424" title="Phenoxymethyl-Penicillin"](pen VK)(250mg) 1+1+1+1……...10 days then prophylaxis
1+0+1 ...continue
2. Tab.[post id="860" title="Aspirin"](Ecosprin) 300mg
- In children:60 mg/kg, divided into six doses
- in Adult: 100mg /kg ,divided dose
3. Tab.[post id="393" title="Pantoprazole"](pantonix) 1+0+1.....15 Days
if carditis or severe arthritis
Tab.[post id="479" title="Prednisolone"](cortan)(10mg) 1-2mg/kg divided dose 3-4 wks then taper
if heart failure:
Tab.[post id="868" title="Digoxin"](agoxin)(0.25mg) once daily with diuretics if needed
If patient Allergic to penicilline
Tab.[post id="432" title="Erythromycin"](Eromycin)500mg
1+1+1+1.....10 days