Rheumatic Fever and Long-term Sequelae in Children

Area of Science:

• Cardiology
• Infectious Diseases
• Rheumatology

Background:

• Rheumatic fever and rheumatic heart disease persist globally, especially affecting young people in developing countries.
• While incidence declined in developed nations due to improved living conditions, outbreaks still occur.
• Penicillin's introduction in the 1940s significantly altered rheumatic fever's course.

Purpose of the Study:

• To review the current understanding of rheumatic fever and rheumatic heart disease management.
• To highlight the importance of secondary prevention strategies.
• To discuss treatment options for carditis and heart failure.

Main Methods:

• Review of existing literature on rheumatic fever and rheumatic heart disease.
• Analysis of treatment protocols including antibiotics and anti-inflammatory drugs.
• Evaluation of surgical interventions for severe cases.

Main Results:

• Treatment involves antibiotics (penicillin) and anti-inflammatory drugs (salicylates, corticosteroids).
• Corticosteroids are preferred for severe carditis, while salicylates suffice for milder cases.
• Valvular regurgitation, not myocarditis, causes heart failure in active carditis, necessitating surgery in severe cases.
• Secondary prevention with benzathine penicillin G is the cornerstone of management.

Conclusions:

• Secondary prevention of rheumatic fever is highly effective and recommended.
• Benzathine penicillin G injections are the preferred method for secondary prophylaxis.
• Development of a rheumatic fever vaccine is still needed.