How to test for rheumatic fever?

Written by Liu Li Ning
Rheumatology
Updated on September 04, 2024
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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
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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 Li Jing
Rheumatology
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Does rheumatic fever spread?

Firstly, rheumatic fever is a group of delayed sequelae caused by an infection of Group A Streptococci, simply put, it refers to a type of reactive arthritis that appears after an upper respiratory tract infection. It is associated with this streptococcus, and mostly occurs during the cold and humid seasons of winter and spring. It can affect people of any age, but is most commonly seen in children aged 5-14 and adolescents. Therefore, it is not a contagious disease, but rather a set of symptoms, such as fever and joint pain, appearing in individuals with weakened immune systems following an upper respiratory tract infection. Some people may even experience valvular heart disease. However, if treated actively in the early stages, the disease usually does not lead to any long-term consequences, unless it goes untreated or is treated under poor medical conditions, which may then result in rheumatic arthritis and rheumatic heart disease.

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Written by Yang Ya Meng
Rheumatology
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Treatment of rheumatic fever with aspirin

Patients with rheumatic fever use aspirin primarily for its anti-inflammatory effects to reduce the inflammatory response. Aspirin also has analgesic properties that can be used to treat symptoms like joint pain associated with rheumatic fever. However, it is crucial to monitor patients taking aspirin for any gastrointestinal reactions, such as stomach pain or black stools. During the use of aspirin, it's important to be vigilant about these gastrointestinal symptoms. Additionally, medications that protect the stomach, such as pantoprazole which reduces stomach acid, can be used to prevent the side effects of aspirin. (Use medication under the guidance of a doctor.)

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Written by Du Rui Xia
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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
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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.)