For a patient with suspected post-streptococcal reactive arthritis who does not meet criteria for acute rheumatic fever and has a normal echocardiogram at presentation, do you prescribe 1 year of antibiotic prophylaxis?

This is a loaded question. Post-Streptococcal reactive arthritis (PSRA) plagued me during my fellowship (many moons ago). There is a fine line between PSRA and rheumatic fever (RF). We rarely see RF in the United States anymore. If I'm convinced it is PSRA and not RF (e.g., RF migratory arthritis qu...

The current recommendation from the AHA is to obtain an echocardiogram, administer one year of antibiotic prophylaxis (after an initial ten-day course of antibiotics), and then obtain a repeat echocardiogram. If the echocardiogram remains normal (no valvular disease) at 1 year, prophylaxis can be di...