[The follow-up in adulthood of subjects with progressive rheumatic disease in childhood. Considerations of secondary prevention].

We reviewed 57 patients who had previously suffered from rheumatic fever (RF) after an average period of 7.2 (+/- 2.8) years without penicillin prophylaxis. In 24 cases (42%) RF began with carditis and in 9 patients valvular damage remained after hospital discharge. Prophylaxis with retard penicillin every four week was carried out for 5.5 +/- 1.8 years. At present the patients are all asymptomatic. There was in 7 cases mild valvular damage without clinical and instrumental involvement. There was not recurrency after the end of prophylaxis, except for a doubtful case, analysed in the Discussion. Although our cases are not numerous, we believe that a regular prophylactic treatment over 5 or 6 years is sufficient to avoid any recurrency in patients with previous RF. After this period of treatment, only subjects with valvular damage should have further extensive treatment until their 20th year and always for a period not shorter than ten years.