Can people with rheumatic fever eat fish?

Written by Yang Ya Meng
Rheumatology
Updated on February 15, 2025
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Patients with rheumatic fever can eat freshwater fish, but should try to eat less fish without scales and sea fish. For patients with rheumatic fever, the general dietary rule is to eat a light diet and reduce consumption of spicy, warming, oily, and rich foods. Foods such as celery, coriander, leeks, seaweed, mushrooms, beef, mutton, dog meat, and longan should be minimized. Seafood, such as shrimp and crab, which are high in protein, should also be consumed less. In addition to dietary considerations, patients with rheumatic fever should also avoid getting cold and pay attention to rest.

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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 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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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
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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.