Is rheumatic fever prone to recurrence?

Written by Yang Ya Meng
Rheumatology
Updated on September 24, 2024
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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 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 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 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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What foods should not be eaten with rheumatic fever?

Patients with rheumatoid fever should avoid the following three major categories of foods: The first category is vegetables, such as celery, coriander, leeks, seaweed, and mushrooms, which should be consumed in moderation. The second category includes meats like lamb, beef, and dog meat, which are very warming and nourishing and should be reduced in consumption. The third category includes seafood such as shrimp, crab, and sea cucumber, which are high in protein and should also be avoided. For patients with rheumatism, the general dietary principle is to follow a light diet, avoid spicy and dry-heat foods, and reduce greasy foods. For patients with rheumatic fever, it is particularly important during the acute phase to rest and avoid catching colds and infections.

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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.