Rheumatic Fever: Arthritis Treatment

Treatment of Migratory Arthritis in Rheumatic fever:

1.       Bed rest for 2 weeks

2.       Anti-inflammatory drug: Salicylates

a.      Dose: 50-70 mg/kg/day (max = 6 gram /day) For 3-5 days

b.      Then 50 mg/kg/d for 3 weeks.

c.       Then gradual withdrawal monitored by decline in ESR & CRP

d.      Side effects: Gastritis, GI bleeding, Reye syndrome

3.      Daily examination is vital to pick carditis that can present within 2 weeks of the onset