In the ongoing dengue problem in Delhi, many respiratory viral infections are presenting with cough and nasal discharge. These patients do not require any antibiotic.
However, school children with any cough should not be ignored and a local family doctor should rule out bacterial sore throat, which if goes undetected, can cause rheumatic involvement of the valves of the heart, a condition called as rheumatic fever.
Such children invariably will have pain in throat while swallowing, red angry–looking tonsils and painful enlargement of lymph nodes at the angle of the mouth. Immediate antibiotics are needed to prevent future involvement of the heart.
Children also should not be given aspirin indiscriminately as it is known to be associated with fatal liver disease, in susceptible children.
The first attack of rheumatic fever is rare after the age of 35.