Rheumatic fever clinical symptoms

Written by Yang Ya Meng
Rheumatology
Updated on September 28, 2024
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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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Is rheumatic fever prone to recurrence?

Rheumatic fever recurs because it is caused by an infection with Group A streptococcus. If the streptococcus is not completely eradicated, recurrence is likely. Therefore, it is critical for patients with rheumatic fever to undergo a full course of anti-infection treatment initially. The most commonly used treatments are antibiotics such as penicillin and second-generation cephalosporins. Additionally, long-acting benzathine penicillin treatment outside the hospital is necessary to completely eradicate the streptococcus, thereby preventing the recurrent episodes of rheumatic fever. If the streptococcus is well-controlled, the likelihood of recurrence of rheumatic fever will be relatively small.

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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 Li Jing
Rheumatology
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What are the symptoms of rheumatic fever?

Rheumatic fever is a delayed, non-suppurative sequelae caused by a streptococcus infection. It primarily presents as arthritis, heart valve disease, chorea, subcutaneous nodules, and erythema, and some cases also exhibit fever. It mainly occurs in adolescents and children aged 5 to 14. It is primarily related to symptoms that appear after an upper respiratory tract streptococcus infection. If the individual has good resistance, symptoms may only resemble those of a cold, such as sore throat, runny nose, and fever, and these symptoms can be relieved after anti-infection treatment without any residual sequelae. However, people with weaker resistance may develop these sequelae after an upper respiratory tract infection, including joint pain and heart valve disease. Therefore, it is crucial to receive proper treatment during the acute phase to prevent any lasting sequelae.

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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
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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.)