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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Written by Yang Ya Meng
Rheumatology
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Can people with rheumatic fever eat fish?

Patients with rheumatic fever can eat freshwater fish, but should try to eat less fish without scales and sea fish. For patients with rheumatic fever, the general dietary rule is to eat a light diet and reduce consumption of spicy, warming, oily, and rich foods. Foods such as celery, coriander, leeks, seaweed, mushrooms, beef, mutton, dog meat, and longan should be minimized. Seafood, such as shrimp and crab, which are high in protein, should also be consumed less. In addition to dietary considerations, patients with rheumatic fever should also avoid getting cold and pay attention to rest.

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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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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.

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Written by Yang Ya Meng
Rheumatology
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How long will it take for rheumatic fever rash to heal?

Rheumatic fever rash generally improves after seven to ten days of treatment, but this is contingent upon completing a full course of antibiotics. This is because the rash is induced by a streptococcal infection. Therefore, to control the infection by streptococcus, the rash will begin to improve. Moreover, if the rash does not subside over time, it may also be considered to strengthen anti-inflammatory treatment with glucocorticoids and anti-allergy treatments to reduce the rash. Additionally, medications like loratadine dispersible tablets and compound glycyrrhizin can be added to help reduce the occurrence of rheumatic fever rash and accelerate its resolution.

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Written by Yang Ya Meng
Rheumatology
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The difference between rheumatic fever and rheumatoid arthritis

The main difference between rheumatic fever and rheumatoid arthritis is that in addition to symptoms of arthritis, rheumatic fever also presents with elevated anti-streptolysin O levels and valvular heart disease, with some patients displaying subcutaneous erythema and chorea-like symptoms. Rheumatoid arthritis, on the other hand, primarily manifests as joint pain, and rarely involves heart valve issues. Additionally, rheumatoid arthritis is characterized by elevated rheumatoid factor, anti-CCP antibodies, and anti-AkA antibodies as its main clinical features. Patients with rheumatoid arthritis also exhibit increased inflammatory markers. The key differences between rheumatic fever and rheumatoid arthritis lie in the different antibodies involved and the general association of rheumatic fever with cardiac involvement.