How to treat rheumatic fever?

Written by Yang Ya Meng
Rheumatology
Updated on September 25, 2024
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Patients with rheumatic fever who develop a fever can first use non-steroidal anti-inflammatory drugs (NSAIDs) such as sustained-release diclofenac sodium tablets for symptomatic fever reduction. At the same time, it is also necessary to actively treat the primary disease of rheumatic fever. If the rheumatic fever is induced by a streptococcal infection, additional anti-infection treatment is also needed. Furthermore, as rheumatic fever is also an autoimmune disease, while using NSAIDs to reduce fever, it is also necessary to add some immunosuppressants, such as methotrexate or leflunomide, to control the condition. Only on the basis of controlling the condition can rheumatic fever potentially be completely cured. (The use of medications should be under the guidance of a doctor.)

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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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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 Liu Li Ning
Rheumatology
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Does rheumatic fever cause an increase in body temperature?

Rheumatic fever may lead to increased body temperature; fever is one of the common clinical manifestations of rheumatic fever, primarily associated with streptococcal infections. Other common symptoms of rheumatic fever include joint pain or arthritis, erythema marginatum, subcutaneous nodules, chorea, and carditis. During the acute phase, penicillin antibiotics can be used to treat the infection. At the same time, it is important to rest adequately and consume high-quality protein foods to ensure sufficient nutrition and calories. Foods rich in high-quality protein such as lean meat, milk, and eggs should be consumed appropriately. In addition, symptomatic treatment is also crucial. For arthritis, non-steroidal anti-inflammatory drugs can be used, and corticosteroids are necessary for treating carditis.

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Written by Yang Ya Meng
Rheumatology
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Symptoms of recurrent rheumatic fever

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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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.