How to test for rheumatic fever?

Written by Liu Li Ning
Rheumatology
Updated on September 04, 2024
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Rheumatic fever is a systemic connective tissue disorder occurring one to four weeks after an infection by Group A Streptococcus, primarily affecting the heart and joints, and commonly infects children and adolescents. The usual clinical manifestations include carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules, joint pain, and fever. Common laboratory tests for this disease include: 1. Complete blood count, often showing mild anemia and a slight increase in white blood cell count. 2. Elevated erythrocyte sedimentation rate. 3. Elevated C-reactive protein. 4. Antistreptolysin-O antibodies often greater than 500 units. 5. Positive throat swab culture. 6. Echocardiogram, which may show vegetations.

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Written by Yang Ya Meng
Rheumatology
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What should be paid attention to in the diet for rheumatic fever?

For patients with rheumatism, the general dietary rule is to follow a light diet, reduce spicy and greasy foods, and avoid foods that are too warm and dry. Specifically, vegetables like celery, coriander, leeks, seaweed, and shiitake mushrooms should be reduced in consumption because they may cause photosensitivity and worsen rheumatism. At the same time, meats such as lamb, dog meat, and beef are considered too warming and nourishing, and may also trigger the worsening of rheumatism, so their consumption should also be minimized. Similarly, seafood like shrimp, crab, and sea cucumber, which are high in protein, might cause allergic reactions in patients with rheumatism, so their intake should be minimized as well.

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Written by Li Jing
Rheumatology
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What are the symptoms of rheumatic fever?

Rheumatic fever is a delayed, non-suppurative sequelae caused by a streptococcus infection. It primarily presents as arthritis, heart valve disease, chorea, subcutaneous nodules, and erythema, and some cases also exhibit fever. It mainly occurs in adolescents and children aged 5 to 14. It is primarily related to symptoms that appear after an upper respiratory tract streptococcus infection. If the individual has good resistance, symptoms may only resemble those of a cold, such as sore throat, runny nose, and fever, and these symptoms can be relieved after anti-infection treatment without any residual sequelae. However, people with weaker resistance may develop these sequelae after an upper respiratory tract infection, including joint pain and heart valve disease. Therefore, it is crucial to receive proper treatment during the acute phase to prevent any lasting sequelae.

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Written by Yang Ya Meng
Rheumatology
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What foods should not be eaten with rheumatic fever?

Patients with rheumatoid fever should avoid the following three major categories of foods: The first category is vegetables, such as celery, coriander, leeks, seaweed, and mushrooms, which should be consumed in moderation. The second category includes meats like lamb, beef, and dog meat, which are very warming and nourishing and should be reduced in consumption. The third category includes seafood such as shrimp, crab, and sea cucumber, which are high in protein and should also be avoided. For patients with rheumatism, the general dietary principle is to follow a light diet, avoid spicy and dry-heat foods, and reduce greasy foods. For patients with rheumatic fever, it is particularly important during the acute phase to rest and avoid catching colds and infections.

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Written by Yang Ya Meng
Rheumatology
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Is rheumatic fever prone to recurrence?

Rheumatic fever recurs because it is caused by an infection with Group A streptococcus. If the streptococcus is not completely eradicated, recurrence is likely. Therefore, it is critical for patients with rheumatic fever to undergo a full course of anti-infection treatment initially. The most commonly used treatments are antibiotics such as penicillin and second-generation cephalosporins. Additionally, long-acting benzathine penicillin treatment outside the hospital is necessary to completely eradicate the streptococcus, thereby preventing the recurrent episodes of rheumatic fever. If the streptococcus is well-controlled, the likelihood of recurrence of rheumatic fever will be relatively small.

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Written by Yang Ya Meng
Rheumatology
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What are the symptoms of rheumatic fever?

In the early stage of rheumatic fever, most patients show signs of infection, such as pharyngitis or tonsillitis. Patients with rheumatic fever often also experience fever, with body temperatures generally ranging from 38 to 40°C. Additionally, there may be migrating arthritis characterized by redness, swelling, warmth, pain, and limited mobility in the joints. Rheumatic fever patients may also suffer from cardiac valve lesions, primarily manifesting as valvulitis, myocarditis, or pericarditis, with damage to the valves being most common. Skin rashes, mainly presenting as ring-shaped erythema or subcutaneous nodules, can also occur. Some patients with rheumatic fever may experience chorea, which are among the primary symptoms of the condition.