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.)