Question

A 15-year-old Aboriginal boy from a remote community presents with fever, migratory polyarthritis and a new pansystolic murmur at the apex 3 weeks after a sore throat. You suspect acute rheumatic fever with carditis. What is the most appropriate immediate management?

Accepted Answer

Admit to hospital for confirmation, echocardiography, initiation of intramuscular benzathine penicillin and supportive therapy

Answer

Discharge with NSAIDs and review in 1 week

Answer

Start oral penicillin and arrange routine cardiology review in 6 months

Answer

Treat with oral steroids alone in the community

Answer

No treatment is required if symptoms settle spontaneously

Practice question

A 15-year-old Aboriginal boy from a remote community presents with fever, migratory polyarthritis and a new pansystolic murmur at the apex 3 weeks after a sore throat. You suspect acute rheumatic fever with carditis. What is the most appropriate immediate management?