Why is the erythrocyte sedimentation rate accelerated in rheumatic fever?

Written by Yang Ya Meng
Rheumatology
Updated on June 04, 2025
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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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Is a hot towel compress useful for rheumatism?

Rheumatic fever is not effectively treated by applying a towel. It is a systemic inflammatory disease caused by an infection of group A beta-hemolytic streptococcus. Clinically, common manifestations include fever, erythema marginatum, subcutaneous nodules, joint pain or arthritis, chorea, and carditis. The heart involvement primarily affects the valves, with the mitral and tricuspid valves being the most commonly affected, leaving many patients with valvular vegetations. The incidence of rheumatic fever has become relatively rare, mainly due to the widespread use of penicillin in recent years. During the acute phase of rheumatic fever, if joint pain occurs, non-steroidal anti-inflammatory drugs such as etoricoxib or meloxicam can be used for treatment.

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Written by Yang Ya Meng
Rheumatology
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Symptoms and Treatment of Rheumatic Fever

Patients with rheumatism often experience symptoms of upper respiratory tract infections in the early stages of the disease, such as fever and sore throat. Additionally, patients with rheumatism commonly exhibit migratory joint pain, primarily characterized by acute onset of redness, swelling, heat, pain, and limited mobility in the joints, but these can improve on their own. Patients with rheumatic fever often also suffer from carditis, which can include valvulitis, myocarditis, and pericarditis, with damage to the valves being the most common. Rheumatic fever may also present with ring-shaped erythema on the skin or subcutaneous nodules, and it can include chorea. The most common treatment for rheumatic fever is the intramuscular injection of penicillin. (Specific medication use should be carried out under the guidance of a doctor.)

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Written by Yang Ya Meng
Rheumatology
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Is the rheumatoid factor high in rheumatic fever?

Patients with rheumatic fever often do not have elevated rheumatoid factor levels, as rheumatic fever primarily follows a streptococcal infection. There is typically an increase in anti-streptolysin O antibodies, while rheumatoid factors are often negative. In addition to elevated anti-streptolysin O, patients with rheumatic fever may also experience valvular heart disease, most commonly mitral stenosis. Some patients may present with skin erythema and symptoms similar to chorea, which leads us to consider the possibility of rheumatic fever. The treatment of rheumatic fever primarily involves regular antibiotic therapy and continued administration of intramuscular benzathine penicillin for a period of time. (The use of medications should be under the guidance of a professional doctor.)

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Written by Yang Ya Meng
Rheumatology
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How to treat rheumatic fever?

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 Yang Ya Meng
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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.