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Rheumatic fever and working with children
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Rheumatic fever and working with children

Dear doctor,
If someone had rheumatic fever in childhood and was left with mild MR and some rhythm abnormalities such as PVCs and infrequent bursts of SVT, do you think is it safe for that person to be working as a nurse in the hospital with children who can potentially have strep infection? I guess what I am asking is what are the chances for an adult with a history of rheumatic fever when exposed to strep throat getting an attack of rheumatic fever again? Is there anything that person should do if he is exposed to kids with strep infection.
Thank you for the information.
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Dear Cathy12,

Rhematic fever is a delayed inflammatory response following a pharyngeal Group A streptococcal infection. Recurrence is most common within two years of the original attack but can happen at any time. Many physicians believe that antibiotic prophylaxis should be continued for at least 10 years following an acute attack. The antibiotic regimens include penicillin V potassium for adults and sulfadiazine for children.  Some physicians feel that once a person has had rheumatic fever they should be on antibiotic prophylaxis indefinitely.
The person in question is at some risk for developing recurrent rheumatic fever. It may be a good idea for this person to take antibiotic prophylaxis. I would recommend seeing an infectious disease specialist and discussing the concerns mentioned in this forum. Hope this helps.


Thanks for your question,

CCF-MD-KE
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