Rheumatic fever arthritis

For a lay person:

Rheumatic fever is an inflammatory reaction that can follow a strep throat infection, mainly in children and young people. It causes painful, swollen joints that move from one joint to another, and can damage the heart valves.

For a trained medical person:

An immune-mediated sequel of group A streptococcal pharyngitis caused by molecular mimicry, with migratory polyarthritis, carditis, chorea, erythema marginatum and subcutaneous nodules. Diagnosis uses the revised Jones criteria with evidence of preceding streptococcal infection (ASO titre or anti-DNase B), inflammatory markers and echocardiography. Treatment is antibiotics to eradicate streptococcus, anti-inflammatory therapy, and long-term secondary antibiotic prophylaxis to prevent recurrence and rheumatic heart disease.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Damp-Heat Type; Wind-Cold-Damp-Heat. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: See a doctor promptly for joint pain and fever after a sore throat, and get urgent care for chest pain, breathlessness or swelling of the legs; this needs antibiotics and medical follow-up, and Chinese medicine is adjunctive at most.