Treatment of rheumatic fever with aspirin

Written by Yang Ya Meng
Rheumatology
Updated on October 22, 2024
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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.)

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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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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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How to treat rheumatic fever arthritis?

Rheumatic fever joint pain initially can be treated with anti-inflammatory and analgesic medications. The most commonly used are non-steroidal anti-inflammatory drugs (NSAIDs), such as slow-release diclofenac sodium tablets. Since rheumatic fever is triggered by a streptococcal infection, if the streptococcus is not controlled, joint pain may reoccur. Therefore, fundamentally, an adequate course of anti-infection treatment is also needed. In the acute phase of rheumatic fever, antibiotics such as penicillin or second-generation cephalosporins can be used for a 10-14 day treatment. Subsequently, treatment may require sequential benzathine penicillin for possibly up to six months or more than a year. (Please use medications under the guidance of a doctor.)

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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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Difference between Rheumatic Fever and Rheumatoid Arthritis

The key difference between rheumatic fever and rheumatoid arthritis primarily lies in the fact that patients with rheumatic fever, besides exhibiting symptoms such as joint pain, also develop cardiac and dermatological manifestations. Patients with rheumatic fever may experience mitral stenosis and symptoms like erythema on the skin. Moreover, the examination of antibodies in rheumatic fever patients mainly shows an elevation in anti-streptolysin O antibody. In contrast, patients with rheumatoid arthritis typically display elevated rheumatoid factor, anti-CCP antibodies, and anti-AKA antibodies, and they seldom have skin or cardiac manifestations. Therefore, to differentiate rheumatic fever from rheumatoid arthritis, one can test for anti-streptolysin O and rheumatoid factor, and further conduct an echocardiogram to determine any cardiac involvement.