A 12-year-old girl presents with fever, migratory polyarthritis and elevated ASO titre and is diagnosed with acute rheumatic fever. She recovers after treatment. As part of the secondary prevention strategy under the national programme for rheumatic fever and rheumatic heart disease control, she should receive:
- A Oral amoxicillin daily for 5 years
- B Monthly benzathine penicillin injections for 6 months only
- C Benzathine penicillin injection every 3 to 4 weeks until age 40 or lifelong if carditis persists ✓
- D Echocardiographic surveillance alone without antibiotic prophylaxis
Correct answer: C. Benzathine penicillin injection every 3 to 4 weeks until age 40 or lifelong if carditis persists
Explanation
Secondary prevention of rheumatic fever aims to prevent recurrent attacks and progression to chronic rheumatic heart disease using continuous chemoprophylaxis with intramuscular benzathine penicillin given every 3 to 4 weeks. Duration depends on severity: 5 years or until age 21 for carditis-free cases, 10 years or longer after carditis, and lifelong or until age 40 for residual valvular disease. Short 6-month courses leave the patient vulnerable to recurrence, and surveillance without antibiotics does not prevent streptococcal reinfection.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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