Does rheumatic fever spread?

Written by Li Jing
Rheumatology
Updated on August 31, 2024
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Firstly, rheumatic fever is a group of delayed sequelae caused by an infection of Group A Streptococci, simply put, it refers to a type of reactive arthritis that appears after an upper respiratory tract infection. It is associated with this streptococcus, and mostly occurs during the cold and humid seasons of winter and spring. It can affect people of any age, but is most commonly seen in children aged 5-14 and adolescents. Therefore, it is not a contagious disease, but rather a set of symptoms, such as fever and joint pain, appearing in individuals with weakened immune systems following an upper respiratory tract infection. Some people may even experience valvular heart disease. However, if treated actively in the early stages, the disease usually does not lead to any long-term consequences, unless it goes untreated or is treated under poor medical conditions, which may then result in rheumatic arthritis and rheumatic heart disease.

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Written by Liu Li Ning
Rheumatology
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Can rheumatic fever be contagious?

Rheumatic fever generally is not contagious. Because the onset of rheumatism is somewhat related to infection by Group A beta-hemolytic streptococcus, and it is not a contagious disease, it does not spread. Common clinical manifestations of rheumatic fever include fever, erythema marginatum, subcutaneous nodules, joint pain, chorea, and carditis. During the acute phase of rheumatism, it is recommended to rest in bed and avoid overexertion. In terms of medical treatment, because it is related to streptococcal infection, penicillin antibiotics are generally recommended. If there is concurrent carditis, corticosteroids should be used in combination to improve the condition.

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Written by Yang Ya Meng
Rheumatology
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Treatment of acute rheumatic fever

The treatment of rheumatic fever includes general treatment, where patients are advised to rest in bed. The second is the use of antibiotics, aimed at eliminating streptococcal infections to prevent recurrent attacks of rheumatic fever. The third is anti-rheumatic treatment, with the preferred choice being non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets. If the patient's rheumatic fever affects the heart, corticosteroid treatment is also required. In addition, to assist in the reduction of corticosteroids, some immunosuppressants need to be added, such as methotrexate and leflunomide, which help control the condition. For the treatment of complications of rheumatic disease, such as concurrent lung infection, antibiotic treatment should also be considered. (The use of medication should be under the guidance of a professional doctor.)

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Written by Yang Ya Meng
Rheumatology
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How long will it take for rheumatic fever rash to heal?

Rheumatic fever rash generally improves after seven to ten days of treatment, but this is contingent upon completing a full course of antibiotics. This is because the rash is induced by a streptococcal infection. Therefore, to control the infection by streptococcus, the rash will begin to improve. Moreover, if the rash does not subside over time, it may also be considered to strengthen anti-inflammatory treatment with glucocorticoids and anti-allergy treatments to reduce the rash. Additionally, medications like loratadine dispersible tablets and compound glycyrrhizin can be added to help reduce the occurrence of rheumatic fever rash and accelerate its resolution.

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Written by Yang Ya Meng
Rheumatology
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Difference between Rheumatic Fever and Rheumatoid Arthritis

The key difference between rheumatic fever and rheumatoid arthritis primarily lies in the fact that patients with rheumatic fever, besides exhibiting symptoms such as joint pain, also develop cardiac and dermatological manifestations. Patients with rheumatic fever may experience mitral stenosis and symptoms like erythema on the skin. Moreover, the examination of antibodies in rheumatic fever patients mainly shows an elevation in anti-streptolysin O antibody. In contrast, patients with rheumatoid arthritis typically display elevated rheumatoid factor, anti-CCP antibodies, and anti-AKA antibodies, and they seldom have skin or cardiac manifestations. Therefore, to differentiate rheumatic fever from rheumatoid arthritis, one can test for anti-streptolysin O and rheumatoid factor, and further conduct an echocardiogram to determine any cardiac involvement.

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Written by Yang Ya Meng
Rheumatology
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Symptoms and Treatment of Rheumatic Fever

Patients with rheumatism often experience symptoms of upper respiratory tract infections in the early stages of the disease, such as fever and sore throat. Additionally, patients with rheumatism commonly exhibit migratory joint pain, primarily characterized by acute onset of redness, swelling, heat, pain, and limited mobility in the joints, but these can improve on their own. Patients with rheumatic fever often also suffer from carditis, which can include valvulitis, myocarditis, and pericarditis, with damage to the valves being the most common. Rheumatic fever may also present with ring-shaped erythema on the skin or subcutaneous nodules, and it can include chorea. The most common treatment for rheumatic fever is the intramuscular injection of penicillin. (Specific medication use should be carried out under the guidance of a doctor.)