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Acute rheumatic fever — RACP Paediatrics MCQ

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HardCardiologyAcute rheumatic feverRACP Paediatrics

A 10-year-old Aboriginal boy from a remote community has migratory ankle and knee arthritis, fever and a new apical systolic murmur. ECG shows prolonged PR interval and antistreptolysin O titre is elevated. What is the most appropriate management?

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Correct answer: D — Treat acute rheumatic fever and start secondary penicillin prophylaxis

The Jones criteria are met in a high-risk child, and management includes treatment of acute rheumatic fever, echocardiography and secondary prophylaxis to prevent recurrence. Viral arthritis would not explain carditis features and prolonged PR in this context. The pearl is that Aboriginal and Torres Strait Islander children in high-risk settings require a low threshold for ARF recognition and register-based follow-up.

Reference: Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease; Therapeutic Guidelines (eTG)