Rheumatic Fever

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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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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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Symptoms of recurrent rheumatic fever

Symptoms of recurrent rheumatic fever in the early stages may include fever and sore throat, similar to streptococcal infections. Later, patients may experience joint pain, some may develop ring-shaped erythema on the skin, and others may develop subcutaneous nodules. Severe cases may even exhibit symptoms such as carditis and chorea. If a previous rheumatic fever patient shows these symptoms, the possibility of recurrence should be considered. Treatment involves using antibiotics to eliminate streptococcal infections. Additionally, anti-inflammatory pain relievers should be used to manage joint pain. In severe cases, such as those with cardiac inflammation, corticosteroids may also be considered. (Please use medication under the guidance of a physician.)

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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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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 Du Rui Xia
Obstetrics
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Symptoms of rheumatic fever in children

Children often show symptoms of rheumatic fever, which commonly leads to myocarditis, arrhythmias, palpitations, and asthma. Additionally, there can be changes in the skin, such as subcutaneous erythema nodosum, as well as joint swelling and pain. There are also general symptoms like fever, fatigue, cough, nosebleeds, abdominal pain, nausea, and vomiting, along with swelling of the lymph nodes throughout the body. During examinations, there is often a significant increase in C-reactive protein and elevated levels of anti-streptococcal antibodies and anti-O. Abnormalities can also be seen on the electrocardiogram. Once symptoms of pediatric rheumatic fever appear, it is crucial to promptly visit a hospital for diagnosis and timely treatment.

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Written by Yang Ya Meng
Rheumatology
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What are the symptoms of rheumatic fever?

In the early stage of rheumatic fever, most patients show signs of infection, such as pharyngitis or tonsillitis. Patients with rheumatic fever often also experience fever, with body temperatures generally ranging from 38 to 40°C. Additionally, there may be migrating arthritis characterized by redness, swelling, warmth, pain, and limited mobility in the joints. Rheumatic fever patients may also suffer from cardiac valve lesions, primarily manifesting as valvulitis, myocarditis, or pericarditis, with damage to the valves being most common. Skin rashes, mainly presenting as ring-shaped erythema or subcutaneous nodules, can also occur. Some patients with rheumatic fever may experience chorea, which are among the primary symptoms of the condition.

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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 Liu Li Ning
Rheumatology
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How to test for rheumatic fever?

Rheumatic fever is a systemic connective tissue disorder occurring one to four weeks after an infection by Group A Streptococcus, primarily affecting the heart and joints, and commonly infects children and adolescents. The usual clinical manifestations include carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules, joint pain, and fever. Common laboratory tests for this disease include: 1. Complete blood count, often showing mild anemia and a slight increase in white blood cell count. 2. Elevated erythrocyte sedimentation rate. 3. Elevated C-reactive protein. 4. Antistreptolysin-O antibodies often greater than 500 units. 5. Positive throat swab culture. 6. Echocardiogram, which may show vegetations.

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Written by Yang Ya Meng
Rheumatology
1min 4sec home-news-image

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.