Symptoms of recurrent rheumatic fever

Written by Yang Ya Meng
Rheumatology
Updated on September 19, 2024
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Symptoms of recurrent rheumatic fever in the early stages may include fever and sore throat, similar to streptococcal infections. Later, patients may experience joint pain, some may develop ring-shaped erythema on the skin, and others may develop subcutaneous nodules. Severe cases may even exhibit symptoms such as carditis and chorea. If a previous rheumatic fever patient shows these symptoms, the possibility of recurrence should be considered. Treatment involves using antibiotics to eliminate streptococcal infections. Additionally, anti-inflammatory pain relievers should be used to manage joint pain. In severe cases, such as those with cardiac inflammation, corticosteroids may also be considered. (Please use medication under the guidance of a physician.)

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Written by Yang Ya Meng
Rheumatology
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Why is the erythrocyte sedimentation rate accelerated in rheumatic fever?

Patients with rheumatic fever exhibit accelerated erythrocyte sedimentation rate (ESR) for two main reasons. The first reason is that rheumatic fever itself is triggered by a streptococcal infection, and infections can also lead to an increase in ESR. The second reason is that patients with rheumatic fever may also experience symptoms such as joint swelling and pain. Aseptic arthritis can also cause an increase in ESR. If a patient with rheumatic fever shows an accelerated ESR, it indicates that the patient is in the acute phase of rheumatic activity. Therefore, the treatment should include the use of anti-inflammatory and pain-relieving drugs, commonly non-steroidal anti-inflammatory drugs like sustained-release diclofenac sodium, and also the use of anti-infective treatments, typically second-generation cephalosporin antibiotics. (Please use medication under the guidance of a physician.)

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

Most patients with rheumatoid arthritis primarily exhibit symptoms related to the joints. Mainly affected are the symmetrical small joints of both hands, including both wrists, both palmar digital joints, and both proximal interphalangeal joints. In addition, patients with rheumatoid arthritis often have elevated rheumatoid factor, anti-CCP antibodies, and AKA antibodies. During the acute phase of joint disease, there is a marked increase in inflammatory markers, which is a major manifestation of rheumatoid arthritis. Patients with rheumatic fever, aside from joint pain, may also have heart valve disorders, such as mitral stenosis, and some patients may develop skin lesions, commonly erythema nodosum. Most importantly, patients with rheumatic conditions often show a significant increase in anti-streptolysin O.

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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 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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Treatment of rheumatic fever with aspirin

Patients with rheumatic fever use aspirin primarily for its anti-inflammatory effects to reduce the inflammatory response. Aspirin also has analgesic properties that can be used to treat symptoms like joint pain associated with rheumatic fever. However, it is crucial to monitor patients taking aspirin for any gastrointestinal reactions, such as stomach pain or black stools. During the use of aspirin, it's important to be vigilant about these gastrointestinal symptoms. Additionally, medications that protect the stomach, such as pantoprazole which reduces stomach acid, can be used to prevent the side effects of aspirin. (Use medication under the guidance of a doctor.)