Acute rheumatic fever

Rheumatic fever is a common acute and chronic inflammation of some connective tissues. It also has many side effects on the heart, joints, central nervous system and skin tissues in the body. Clinically, it manifests as carditis, arthritis, chorea, subcutaneous nodules and annular erythema. It is also accompanied by some fever, subcutaneous nodules and some symptoms of chorea. Arthritis is the most obvious during the attack. Some rheumatic heart diseases can be fatal.

It is mainly mild proteinuria in urine routine, but the function is generally normal. In daily life, its differential diagnosis is also based on different causes and some different periods. It is necessary to pay attention to some routine examinations and treatments for acute rheumatic fever.

If urine routine test does not return to normal for a long time, it should be differentiated from IgA nephritis; renal biopsy is helpful to differentiate it from acute glomerulonephritis.

In the treatment of acute rheumatic fever, the main focus is on tracking and observing changes in the kidneys, and paying attention to differential diagnosis. Because this disease is short-term and self-limiting, no special treatment is required and it generally improves or returns to normal as the rheumatic fever improves. If hematuria is obvious, refer to the treatment of IgA nephritis.

The clinical manifestations of acute rheumatic fever are very complex, but still have certain regularities. Certain clinical manifestations are characteristic of acute rheumatic fever and are decisive for the diagnosis. They are called cardinal manifestations or main signs, including carditis, arthritis, chorea, subcutaneous nodules, and annular erythema. Although other manifestations also commonly occur, they are not specific and only play an auxiliary role in diagnosis. They are called secondary manifestations or secondary symptoms, including joint pain, fever, rheumatic heart disease and previous medical history. Certain laboratory tests, such as prolonged PR interval on the electrocardiogram, the presence of acute reactants in the blood, including increased erythrocyte sedimentation rate and positive C-reactive protein, may also serve as secondary manifestations.

Acute rheumatic fever can be divided into three stages according to the order of onset:

(1) Prodromal stage of streptococcal infection: manifested as upper respiratory tract infections such as tonsillitis and pharyngitis.

(2) Incubation period: There is a period of incubation, remission and dormancy between upper respiratory tract infection and acute rheumatic fever attack, which lasts about 1 to 4 weeks. Patients at this stage had no clinical symptoms.

(3) Acute rheumatic fever attack period: Most cases have an acute onset, but can also be slow, or even asymptomatic and progress in an insidious manner. Common symptoms include fever, excessive sweating, fatigue, loss of appetite, weight loss, and symptoms of damaged organs. If there is carditis, there may be palpitations, shortness of breath, chest tightness, and even paleness, anxiety, and irritability. When you have arthritis, you may experience redness and swelling of the joints, migratory pain, and difficulty in movement. Skin lesions mainly manifest as subcutaneous nodules and annular erythema. Children often have symptoms such as nose bleeding and abdominal pain.

The above are the common symptoms of acute rheumatic fever, which are generally normal. The differential diagnosis in daily life is also based on different causes and some different periods. A good diagnosis can be made. You can eat more fruits and vegetables in your life and try to eat less spicy and taboo foods. Eating them together will have a very good effect in daily life.