12th March 2024

Management

Goals of management include:

• Eradication of underlying streptococcal infection. Once a pharyngeal culture is obtained, patients are usually started on penicillin. Following an episode of rheumatic fever, antibiotic prophylaxis is recommended to prevent further episodes. 
• Suppression of the pathological immune response. NSAIDs may help relieve arthritis and arthralgia. 
• Supportive management with angiotensin-converting-enzyme inhibitors and diuretics in rheumatic fever complicated by heart failure and severe aortic regurgitation. Cardiac valve replacement or repair may also be indicated.