Treatment of acute rheumatic fever

Written by Yang Ya Meng
Rheumatology
Updated on September 29, 2024
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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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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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Does rheumatic fever spread?

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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Is rheumatism hot compress useful?

Hot compresses for rheumatic diseases can alleviate joint pain by increasing the local skin temperature, and have a certain effect in relieving joint swelling and pain. However, they cannot fundamentally solve the problem. Rheumatic diseases still require chronic oral medication treatment. The commonly used medications for treating rheumatic diseases fall into three main categories. The first category consists of drugs that control pain symptoms, which we call anti-inflammatory analgesics, commonly including medications like celecoxib. Additionally, to control the progression of rheumatism, it is also necessary to use some immunosuppressants, with the most common being methotrexate and leflunomide. If the above methods are not effective, we may consider treatment with biologics. (Medication should be administered under the guidance of a doctor.)

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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 Yang Ya Meng
Rheumatology
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Rheumatic fever clinical symptoms

The clinical manifestations of rheumatic fever primarily include: Some patients may experience low fever and rashes, and about half of the patients may exhibit symptoms such as morning stiffness. The joint pain associated with rheumatic fever often occurs more frequently in the large joints of the lower limbs and is asymmetrical, but it can also affect small joints and central axis joints. It commonly presents as non-migratory arthritis. Secondly, patients with rheumatic fever may experience cardiac involvement, with the most common being heart valve disease, particularly mitral valve stenosis. Additionally, patients with rheumatic fever may also suffer from kidney involvement, often presenting with symptoms such as hematuria and proteinuria, which are typical clinical symptoms of rheumatism.