Acute rheumatic fever - Revision history

Danbot: Add MedicationDose entries for aspirin, prednisone

2026-03-20T21:16:23Z

Add MedicationDose entries for aspirin, prednisone

← Older revision		Revision as of 21:16, 20 March 2026
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	* [https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html/ CDC guidelines for GAS Disease]		* [https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html/ CDC guidelines for GAS Disease]


			==Medication Dosing==
			{{MedicationDose
			\| drug = Aspirin
			\| dose = 50-100mg/kg/day PO divided q4-6h
			\| route = PO
			\| context = Anti-inflammatory for carditis/arthritis
			\| indication = Acute rheumatic fever
			\| population = Pediatric
			}}
			{{MedicationDose
			\| drug = Prednisone
			\| dose = 1-2mg/kg/day PO
			\| route = PO
			\| context = Moderate-to-severe carditis
			\| indication = Acute rheumatic fever
			\| population = Pediatric
			}}

	==See Also== <!--T:20-->		==See Also== <!--T:20-->

Ostermayer: Marked this version for translation

2026-01-04T15:00:19Z

Marked this version for translation

← Older revision		Revision as of 15:00, 4 January 2026
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	<translate>		<translate>

	==Background==		==Background== <!--T:1-->

			<!--T:2-->
	*Primarily affects school age children 2-6 weeks after Group A [[Special:MyLanguage/streptococcal pharyngitis\|streptococcal pharyngitis]]		*Primarily affects school age children 2-6 weeks after Group A [[Special:MyLanguage/streptococcal pharyngitis\|streptococcal pharyngitis]]
	**Is not associated with [[Special:MyLanguage/impetigo\|impetigo]]		**Is not associated with [[Special:MyLanguage/impetigo\|impetigo]]
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	==Clinical Features==		==Clinical Features== <!--T:3-->

			<!--T:4-->
	*[[Special:MyLanguage/Arthritis\|Polyarthritis]]		*[[Special:MyLanguage/Arthritis\|Polyarthritis]]
	**Most common symptom (~75%)		**Most common symptom (~75%)
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	==Differential Diagnosis==		==Differential Diagnosis== <!--T:5-->

			<!--T:6-->
	*[[Special:MyLanguage/Scarlet fever\|Scarlet fever]]		*[[Special:MyLanguage/Scarlet fever\|Scarlet fever]]
	*[[Special:MyLanguage/Kawasaki Disease\|Kawasaki Disease]]		*[[Special:MyLanguage/Kawasaki Disease\|Kawasaki Disease]]
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	==Evaluation==		==Evaluation== <!--T:7-->


	===Work-Up===		===Work-Up=== <!--T:8-->

			<!--T:9-->
	*CBC		*CBC
	*[[Special:MyLanguage/ECG\|ECG]]		*[[Special:MyLanguage/ECG\|ECG]]
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	===Modified Jones Criteria (1992) for Acute Rheumatic Fever===		===Modified Jones Criteria (1992) for Acute Rheumatic Fever=== <!--T:10-->

			<!--T:11-->
	''REQUIRE: 2 major or 1 major and 2 minor criteria and evidence of previous GAS pharyngitis''		''REQUIRE: 2 major or 1 major and 2 minor criteria and evidence of previous GAS pharyngitis''
	*Major diagnostic criteria (CASES)		*Major diagnostic criteria (CASES)
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	==Management==		==Management== <!--T:12-->

			<!--T:13-->
	*[[Special:MyLanguage/Penicillin\|Penicillin]] - Indicated for all with rheumatic fever even if culture for [[Special:MyLanguage/strep\|strep]] is negative		*[[Special:MyLanguage/Penicillin\|Penicillin]] - Indicated for all with rheumatic fever even if culture for [[Special:MyLanguage/strep\|strep]] is negative
	**[[Special:MyLanguage/Penicillin G\|Penicillin G]] 600K units IM if <27 kg, 1.2 million units IM if >27 kg		**[[Special:MyLanguage/Penicillin G\|Penicillin G]] 600K units IM if <27 kg, 1.2 million units IM if >27 kg
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	==Complications==		==Complications== <!--T:14-->

			<!--T:15-->
	*Rheumatic Heart Disease		*Rheumatic Heart Disease
	**Worldwide most common cause of valvular heart disease		**Worldwide most common cause of valvular heart disease
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	==Disposition==		==Disposition== <!--T:16-->

			<!--T:17-->
	*Admit		*Admit


	==External Links==		==External Links== <!--T:18-->

			<!--T:19-->
	* [http://www.emdocs.net/an-understated-myth-strep-throat-rheumatic-fever/ emDocs - An Understated Myth? Strep Throat & Rheumatic Fever]		* [http://www.emdocs.net/an-understated-myth-strep-throat-rheumatic-fever/ emDocs - An Understated Myth? Strep Throat & Rheumatic Fever]
	* [https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html/ CDC guidelines for GAS Disease]		* [https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html/ CDC guidelines for GAS Disease]


	==See Also==		==See Also== <!--T:20-->

			<!--T:21-->
	*[[Special:MyLanguage/Sydenham's chorea\|Sydenham's chorea]]		*[[Special:MyLanguage/Sydenham's chorea\|Sydenham's chorea]]


	==References==		==References== <!--T:22-->

			<!--T:23-->
	<references/>		<references/>

			<!--T:24-->
	[[Category:Pediatrics]]		[[Category:Pediatrics]]
	[[Category:ID]]		[[Category:ID]]
	[[Category:Cardiology]]		[[Category:Cardiology]]
	</translate>		</translate>

Ostermayer: Prepared the page for translation

2026-01-04T14:57:30Z

Prepared the page for translation

Show changes

Moomoodoctor: /* Management */

2024-05-03T21:48:07Z

Management

← Older revision		Revision as of 21:48, 3 May 2024
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	*Chorea - It is self limited but several agents had been described as effective, although not well studied		*Chorea - It is self limited but several agents had been described as effective, although not well studied
	**[[Haloperidol]] 0.01-0.03mg/kg/day in four divided doses		**[[Haloperidol]] 0.01-0.03mg/kg/day in four divided doses
	**[[~~Valproic Acid~~]]		**[[Valproate]]
	**[[Diazepam]]		**[[Diazepam]]
	**[[Phenobarbital]]		**[[Phenobarbital]]

Moomoodoctor: /* Management */

2024-05-03T21:46:43Z

Management

← Older revision		Revision as of 21:46, 3 May 2024
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	**[[Valproic Acid]]		**[[Valproic Acid]]
	**[[Diazepam]]		**[[Diazepam]]
	**[[~~Phenoparbital~~]]		**[[Phenobarbital]]
	**[[Chlorpromazine]]		**[[Chlorpromazine]]

Moomoodoctor: /* Management */

2024-05-03T21:45:07Z

Management

← Older revision		Revision as of 21:45, 3 May 2024
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	*Carditis		*Carditis
	**Aspirin is primary treatment		**Aspirin is primary treatment
	**[[Prednisone]] 1-2mg/kg/day has no benefit over aspirin in proventing heart disease at one year		**[[Prednisone]] 1-2mg/kg/day has no benefit over aspirin in proventing heart disease at one year <ref> Cilliers A, Adler AJ, Saloojee H. Anti-inflammatory treatment for carditis in acute rheumatic fever.Cochrane Database Syst Rev. 2015 </ref>
	***Some consider for severe carditis		***Some consider for severe carditis
	**Standard medical therapy for [[Congestive Heart Failure]]		**Standard medical therapy for [[Congestive Heart Failure]]

Moomoodoctor: /* Management */

2024-05-03T21:42:50Z

Management

← Older revision		Revision as of 21:42, 3 May 2024
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	**High-dose [[aspirin]] therapy (50-100mg/kg/day) has historically been first line		**High-dose [[aspirin]] therapy (50-100mg/kg/day) has historically been first line
	**Naproxen may be just as effective with less frequent dosing and fewer side effects <ref>The efficacy and safety of naproxen in acute rheumatic fever: The comparative results of 11-year experience with acetylsalicylic acid and naproxen.Turk J Pediatr. 2016;58(5):473. </ref>		**Naproxen may be just as effective with less frequent dosing and fewer side effects <ref>The efficacy and safety of naproxen in acute rheumatic fever: The comparative results of 11-year experience with acetylsalicylic acid and naproxen.Turk J Pediatr. 2016;58(5):473. </ref>
	*Carditis - [[Prednisone]] 1-2mg/kg/day		*Carditis
			**Aspirin is primary treatment
			**[[Prednisone]] 1-2mg/kg/day has no benefit over aspirin in proventing heart disease at one year
			***Some consider for severe carditis
			**Standard medical therapy for [[Congestive Heart Failure]]
	*Chorea - It is self limited but several agents had been described as effective, although not well studied		*Chorea - It is self limited but several agents had been described as effective, although not well studied
	**[[Haloperidol]] 0.01-0.03mg/kg/day in four divided doses		**[[Haloperidol]] 0.01-0.03mg/kg/day in four divided doses

Moomoodoctor: /* Management */

2024-05-03T21:25:06Z

Management

← Older revision		Revision as of 21:25, 3 May 2024
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	**Naproxen may be just as effective with less frequent dosing and fewer side effects <ref>The efficacy and safety of naproxen in acute rheumatic fever: The comparative results of 11-year experience with acetylsalicylic acid and naproxen.Turk J Pediatr. 2016;58(5):473. </ref>		**Naproxen may be just as effective with less frequent dosing and fewer side effects <ref>The efficacy and safety of naproxen in acute rheumatic fever: The comparative results of 11-year experience with acetylsalicylic acid and naproxen.Turk J Pediatr. 2016;58(5):473. </ref>
	*Carditis - [[Prednisone]] 1-2mg/kg/day		*Carditis - [[Prednisone]] 1-2mg/kg/day
	*Chorea - [[Haloperidol]] 0.01-0.03mg/kg/day in four divided doses		*Chorea - It is self limited but several agents had been described as effective, although not well studied
			**[[Haloperidol]] 0.01-0.03mg/kg/day in four divided doses
			**[[Valproic Acid]]
			**[[Diazepam]]
			**[[Phenoparbital]]
			**[[Chlorpromazine]]

	==Complications==		==Complications==

Moomoodoctor: /* Management */

2024-05-03T21:19:26Z

Management

← Older revision		Revision as of 21:19, 3 May 2024
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	\| 10 years since last episode and at least until age 40 years; most commonly lifelong		\| 10 years since last episode and at least until age 40 years; most commonly lifelong
	\|}		\|}
	*Arthritis ~~- high~~-dose [[aspirin]] therapy (75-100mg/kg/day)		*Arthritis
			**High-dose [[aspirin]] therapy (50-100mg/kg/day) has historically been first line
			**Naproxen may be just as effective with less frequent dosing and fewer side effects <ref>The efficacy and safety of naproxen in acute rheumatic fever: The comparative results of 11-year experience with acetylsalicylic acid and naproxen.Turk J Pediatr. 2016;58(5):473. </ref>
	*Carditis - [[Prednisone]] 1-2mg/kg/day		*Carditis - [[Prednisone]] 1-2mg/kg/day
	*Chorea - [[Haloperidol]] 0.01-0.03mg/kg/day in four divided doses		*Chorea - [[Haloperidol]] 0.01-0.03mg/kg/day in four divided doses

Moomoodoctor: /* External Links */

2024-05-03T21:10:40Z

External Links

← Older revision		Revision as of 21:10, 3 May 2024
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	==External Links==		==External Links==
	* [http://www.emdocs.net/an-understated-myth-strep-throat-rheumatic-fever/ emDocs - An Understated Myth? Strep Throat & Rheumatic Fever]		* [http://www.emdocs.net/an-understated-myth-strep-throat-rheumatic-fever/ emDocs - An Understated Myth? Strep Throat & Rheumatic Fever]
			* [https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html/ CDC guidelines for GAS Disease]

	==See Also==		==See Also==