Symptoms and Treatment of Rheumatic Fever

Written by Yang Ya Meng
Rheumatology
Updated on September 13, 2024
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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.)

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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.

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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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Can you soak your feet if you have rheumatic fever?

Patients with rheumatic fever can relieve some joint pain by soaking their feet, but this does not fundamentally solve the problem. Rheumatic fever is often caused by streptococcal infection, which leads to diseases such as arthritis. Therefore, antibiotics should be used at the source to eliminate streptococcal infection and hence prevent the recurrence of rheumatism. Additionally, we can use anti-inflammatory and analgesic drugs to control joint pain. Commonly used anti-inflammatory analgesics include non-steroidal pain relievers, such as diclofenac sodium sustained-release tablets. If there is inflammation in the heart due to rheumatic fever, corticosteroid treatment should be considered. (Medication should be used under the guidance of a doctor.)

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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 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.