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 Yang Ya Meng
Rheumatology
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What tests are needed for rheumatic fever?

The examinations for rheumatic fever include laboratory tests and electrocardiograms, as well as imaging studies. Laboratory tests include indicators of streptococcal infection, commonly using throat swab bacterial cultures, which have a positivity rate of about 20% to 25%. They also include anti-streptolysin O tests, generally considered positive if the titer is above 1:400. Secondly, the tests include those for acute inflammatory response, common markers of which are elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Electrocardiograms help in detecting various arrhythmias, such as sinus tachycardia and prolonged PR interval. Echocardiography can be used to detect any abnormalities in the mitral valve of the heart.

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Written by Yang Ya Meng
Rheumatology
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The difference between rheumatic fever and rheumatoid arthritis

Patients with rheumatoid arthritis primarily exhibit symmetrical swelling and pain in the small joints of both hands as the main clinical manifestations, with rarely any involvement of visceral organs. Blood tests can show elevated inflammatory markers, erythrocyte sedimentation rate (ESR), C-reactive protein, as well as positive rheumatoid factor, anti-CCP antibodies, and AK antibodies. These indicators can be considered as diagnostic for rheumatoid arthritis. Patients with rheumatic fever, in addition to joint pain, often have cardiac complications, such as mitral stenosis or chorea-like symptoms. The main difference between rheumatic fever and internal rheumatism is that patients with rheumatic fever often have cardiac complications.

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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 Liu Li Ning
Rheumatology
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Rheumatic fever anti-O titer generally how much?

Rheumatic fever anti-streptolysin O is generally above the upper limit of the normal range. Since each hospital uses different testing methods, there are differences. You need to determine based on the reference range of your local hospital laboratory what is normal and what exceeds the normal range. Anti-streptolysin O, also known as anti-O, is typically abnormal in cases of rheumatic fever. Rheumatic fever is a systemic inflammatory disease caused by an infection with Group A beta-hemolytic streptococcus. Clinically, it is primarily characterized by fever, erythema marginatum, joint pain, subcutaneous nodules, and it can also include carditis. Some patients may exhibit symptoms of chorea.

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Written by Yang Ya Meng
Rheumatology
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Is the rheumatoid factor high in rheumatic fever?

Patients with rheumatic fever often do not have elevated rheumatoid factor levels, as rheumatic fever primarily follows a streptococcal infection. There is typically an increase in anti-streptolysin O antibodies, while rheumatoid factors are often negative. In addition to elevated anti-streptolysin O, patients with rheumatic fever may also experience valvular heart disease, most commonly mitral stenosis. Some patients may present with skin erythema and symptoms similar to chorea, which leads us to consider the possibility of rheumatic fever. The treatment of rheumatic fever primarily involves regular antibiotic therapy and continued administration of intramuscular benzathine penicillin for a period of time. (The use of medications should be under the guidance of a professional doctor.)