What are the symptoms of rheumatic fever?
Rheumatic fever is an autoimmune disease caused by infection with group A beta-hemolytic Streptococcus and mainly affects the heart, joints, skin and nervous system. The incidence of rheumatic fever has declined in recent years, but it remains a significant health problem in some developing countries and areas with poor medical conditions. This article will detail the symptoms, diagnosis, and treatment of rheumatic fever and provide structured data for better understanding.
1. Common symptoms of rheumatic fever
Symptoms of rheumatic fever usually appear 2-4 weeks after a strep infection and include the following:
| Symptom Category | Specific performance |
|---|---|
| joint symptoms | Migratory arthritis mainly affects large joints (such as knees, ankles, elbows, and wrists) and is characterized by redness, swelling, pain, and limited movement. |
| heart symptoms | Pericarditis, myocarditis or endocarditis may cause palpitations, chest pain, difficulty breathing, and in severe cases may develop into chronic rheumatic heart disease |
| skin symptoms | Annular erythema (erythema with clear edges) or subcutaneous nodules (mostly seen on the extensor side of the joint) |
| neurological symptoms | Sydenham's chorea, characterized by rapid involuntary movements, emotional instability, and muscle weakness |
| Other symptoms | Systemic symptoms such as fever, fatigue, and loss of appetite |
2. Diagnostic criteria for rheumatic fever
The diagnosis of rheumatic fever is mainly based on the revised Jones criteria, including major and minor criteria:
| Main criteria | secondary criteria |
|---|---|
| carditis | joint pain |
| polyarthritis | Fever (≥38.5°C) |
| minor chorea | Increased erythrocyte sedimentation rate or elevated C-reactive protein |
| annular erythema | Prolonged PR interval on electrocardiogram |
| subcutaneous nodules | Previous history of rheumatic fever or rheumatic heart disease |
Diagnostic requirements: 2 major criteria or 1 major criterion plus 2 minor criteria, and evidence of recent streptococcal infection (such as elevated ASO titer or positive throat swab culture).
3. Treatment methods for rheumatic fever
The treatment of rheumatic fever mainly includes the following aspects:
| treatment goals | Specific measures |
|---|---|
| Control symptoms | Use nonsteroidal anti-inflammatory drugs (such as aspirin) to relieve arthritis and fever; patients with severe carditis may need corticosteroids |
| Eradication of Streptococcus | Penicillin is the antibiotic of choice (orally or intramuscularly), and those allergic to penicillin can use erythromycin or other macrolides. |
| Prevent recurrence | Long-term prophylactic antibiotics (usually until age 21 or at least 5 years, or longer if you have heart damage) |
| Complication management | Severe heart valve disease may require surgical repair or replacement; symptoms of minor chorea can be controlled with sedatives or anti-epileptic drugs |
4. Preventive measures for rheumatic fever
The key to preventing rheumatic fever is prompt treatment of strep throat:
1. Rapid diagnosis and treatment of patients with acute pharyngitis, especially children and adolescents.
2. Complete the entire course of antibiotics, even if symptoms have resolved.
3. Improve living conditions and reduce the chance of streptococcus transmission.
4. Provide long-term antibiotic prophylaxis to patients with a history of rheumatic fever.
5. Prognosis of rheumatic fever
The prognosis for rheumatic fever depends on the extent of heart involvement:
| Heart involvement | prognosis |
|---|---|
| No carditis | Usually complete recovery, low risk of recurrence |
| mild carditis | Mild valvular disease may remain but usually does not affect lifespan |
| severe carditis | May develop chronic rheumatic heart disease requiring long-term follow-up and treatment |
Early diagnosis and standardized treatment can significantly improve the prognosis of rheumatic fever. Therefore, you should seek medical attention promptly when you develop suspected symptoms, especially for children and adolescents with a history of streptococcal infection.
Although rheumatic fever is less common than before, it is still a disease that requires attention. Understanding the symptoms, seeking prompt medical attention, and following your doctor's treatment instructions are the keys to preventing serious complications. Through the structured data in this article, we hope to help readers have a clearer understanding of the clinical manifestations and treatment methods of rheumatic fever.
check the details
check the details
en
