Sunday, December 24, 2023

A school-age child with fever and joint pain has just received a diagnosis of rheumatic fever.. Early detection and treatment of streptococcal infections



A school-age child with fever and joint pain has just received a diagnosis of rheumatic fever.

The child’s parents ask the nurse whether anything could have prevented this disorder. Which intervention is most effective in preventing rheumatic fever?
  • a. Immunization with the hepatitis B vaccine.
  • b. Isolation of individuals with rheumatic fever.
  • c. Use of prophylactic antibiotics for invasive procedures.
  • d. Early detection and treatment of streptococcal infections.

Answer D.

Rheumatic fever is a systemic inflammatory disease that follows a Group A streptococcal infection. Therefore, early detection and treatment of streptococcal infections helps prevent the development of rheumatic fever.
Hepatitis B vaccine provides immunity against the hepatitis B virus - not streptococci. Because rheumatic fever isn’t contagious, isolation measures aren’t necessary. Prophylactic antibiotics are used for invasive procedures only in clients with a history of carditis to prevent bacterial endocarditis.

The most effective intervention in preventing rheumatic fever is d. Early detection and treatment of streptococcal infections.


Here's why:
  • Rheumatic fever is an inflammatory disease that can develop as a complication of untreated streptococcal throat infections, particularly those caused by group A Streptococcus (GAS) bacteria.
  • By promptly identifying and treating these infections with appropriate antibiotics, the risk of developing rheumatic fever significantly decreases.
  • While the other options listed may offer some benefits, they are not as effective as early and proper treatment of streptococcal infections in preventing rheumatic fever:

a. Immunization with the hepatitis B vaccine:

This vaccine protects against hepatitis B virus infection, which is unrelated to rheumatic fever.

b. Isolation of individuals with rheumatic fever:

While isolating individuals with rheumatic fever can help prevent the spread of GAS, it does not prevent the initial development of the disease.

c. Use of prophylactic antibiotics for invasive procedures:

This practice is mainly used to prevent infections like endocarditis after certain medical procedures, not to prevent rheumatic fever.

Therefore, emphasizing the importance of early and proper treatment of streptococcal infections is the most effective approach to preventing rheumatic fever in children.