Does rheumatic fever spread?

Written by Li Jing
Rheumatology
Updated on August 31, 2024
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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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Difference between Rheumatic Fever and Rheumatoid Arthritis

The key difference between rheumatic fever and rheumatoid arthritis primarily lies in the fact that patients with rheumatic fever, besides exhibiting symptoms such as joint pain, also develop cardiac and dermatological manifestations. Patients with rheumatic fever may experience mitral stenosis and symptoms like erythema on the skin. Moreover, the examination of antibodies in rheumatic fever patients mainly shows an elevation in anti-streptolysin O antibody. In contrast, patients with rheumatoid arthritis typically display elevated rheumatoid factor, anti-CCP antibodies, and anti-AKA antibodies, and they seldom have skin or cardiac manifestations. Therefore, to differentiate rheumatic fever from rheumatoid arthritis, one can test for anti-streptolysin O and rheumatoid factor, and further conduct an echocardiogram to determine any cardiac involvement.

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Written by Yang Ya Meng
Rheumatology
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Treatment of acute rheumatic fever

The treatment of rheumatic fever includes general treatment, where patients are advised to rest in bed. The second is the use of antibiotics, aimed at eliminating streptococcal infections to prevent recurrent attacks of rheumatic fever. The third is anti-rheumatic treatment, with the preferred choice being non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets. If the patient's rheumatic fever affects the heart, corticosteroid treatment is also required. In addition, to assist in the reduction of corticosteroids, some immunosuppressants need to be added, such as methotrexate and leflunomide, which help control the condition. For the treatment of complications of rheumatic disease, such as concurrent lung infection, antibiotic treatment should also be considered. (The use of medication should be under the guidance of a professional doctor.)

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Written by Liu Li Ning
Rheumatology
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How to quickly relieve rheumatic fever pain?

Rheumatic fever pain can be treated with non-steroidal anti-inflammatory drugs (NSAIDs) for rapid pain relief. NSAIDs are the first-line medications for treating rheumatic fever pain. Commonly used ones include diclofenac sodium sustained-release capsules, etoricoxib, meloxicam, or etodolac. These medications may cause gastrointestinal discomfort, so they cannot be used by patients with active peptic ulcers. If there are contraindications to using NSAIDs, pain relief can be achieved with medications such as tramadol or Aconitum alkaloid tablets. If rheumatic fever is accompanied by carditis, treatment with corticosteroids is also necessary. Since the onset of rheumatic fever is related to streptococcal infections, the use of penicillin antibiotics for anti-infection treatment is also recommended.

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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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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.)