Rheumatic fever is not caused by a bacterium, but is a complication of a streptococcal infection.

Written by Liu Li Ning
Rheumatology
Updated on June 01, 2025
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Rheumatic fever is associated with Group A beta-hemolytic streptococcal infection and is a systemic inflammatory disease. The detailed pathogenesis is not yet very clear. Common clinical manifestations include joint pain, subcutaneous nodules, erythema marginatum, fever, chorea, and carditis. The characteristic of joint pain is that it generally does not leave joint deformities, and presents as migratory pain in the large joints of the limbs. Carditis can affect the heart valves and endocardium, primarily commonly involving the mitral or tricuspid valves. During the acute phase, penicillin antibiotics are needed for anti-infective treatment.

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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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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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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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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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Why is the erythrocyte sedimentation rate accelerated in rheumatic fever?

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.)