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 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 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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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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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.

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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.