Rheumatoid arthritis and fever

Contents

Does Rheumatoid Arthritis Cause Fevers?

The short answer: yes. Fever is actually one of those early subtle symptoms of rheumatoid arthritis (RA) that you might overlook or chalk up to something else.

In up to one-third of people with rheumatoid arthritis, the telltale RA joint pain occurs with “systemic” (or all-over) symptoms that include fatigue, muscle pain, mood changes, and low-grade fever, according to UpToDate. Some patients describe these non-joint symptoms of RA as being “flu-like” — that general yucky feeling you get when you’re on the verge of getting sick.

Normal body temperature ranges from 97°F to 99°F. A low-grade fever is generally considered less than 101°F.

Why Does Rheumatoid Arthritis Cause Fever?

The reason low-grade fever is common among RA patients has to do with how your body’s immune system works. When your immune system is revved up — say, to fight a cold or flu virus that’s entered your body — it produces a number of proteins that take different actions to attack the germs and get you healthy again. Fever can occur as a result of this immune system activation.

With an inflammatory autoimmune disease like rheumatoid arthritis, your immune system is switched on, but is attacking your body’s own tissues rather than a foreign invader like a virus or bacteria. This autoimmune response is what can cause a low-grade fever in rheumatoid arthritis.

Once you get diagnosed with RA and start treatment — which typically includes a disease-modifying drug or biologic to act on the immune system and stop unnecessary inflammation — systemic RA symptoms such fever and fatigue should improve too. However, you may develop low-grade fever every now and then as your RA disease activity ebbs and flows.

“Fever is not a disease ; it is a manifestation of some inflammatory process that could be rheumatoid arthritis, infections, or something else,” says Alexa Meara, MD, a rheumatologist at The Ohio State University Wexner Medical Center in Columbus, Ohio.

Rheumatoid Arthritis Fever and Infection Risk

While your overactive immune system may cause fever, it’s also important to remember the other reason fevers occur: because you’re fighting an infection, such as a virus (cold or flu) or bacteria (strep throat).

Certain medications you take to manage your arthritis suppress your immune system, which makes you more vulnerable to infection than the general population, says Yvonne Lee, MD, an associate professor of rheumatology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine rheumatologist.

So if you develop a fever and have already been diagnosed with rheumatoid arthritis, it could be because you’re sick — and not just part of your usual disease activity.

When to Tell Your Doctor About Having a Fever

If you have a fever of more than 100.4°F, tell your doctor, Dr. Meara advises. They can help figure out if you’re fighting an infection and determine whether you need additional medical care.

“It’s really important to get evaluated to see if you need antibiotics or further treatment because we don’t want any potential infection to get out of hand,” Dr. Lee says. “Get it evaluated by either your primary care physician or your rheumatologist. Don’t assume it’s your RA and carry on.”

Depending on the situation, your doctor may advise you to stop certain RA medications while you’re sick with an infection. However, never stop taking any medication you take to treat RA without first consulting your doctor.

While temporarily stopping certain immune-modifying medications can allow your body to heal itself by re-engaging your immune system’s natural fighting abilities, this isn’t always necessary or a good idea, depending on your dosing schedule and other factors. Stopping medication may let the body heal itself, but may also worsen your RA symptoms.

“Sometimes it does become a catch-22, and really depends on the situation, the patient, and their disease,” Dr. Meara says.

How to Treat Fevers When You Have Rheumatoid Arthritis

Most of the time, you can treat RA fevers the same way you would treat any other fever:

  • Take an over-the-counter medication such as acetaminophen or ibuprofen (check with your doctor to make sure they are safe to take with any other medications you’re on)
  • Drink plenty of fluids
  • Dress in layers so you can stay warm if you get chills and disrobe if you get hot
  • Place a cold compress on your forehead or neck
  • Nap, rest, and get a good night’s sleep

Fever as a Symptom of Rheumatoid Arthritis Flares

Fever may be a sign of an RA flare coming on, but Dr. Meara says it’s very dependent on your individual disease. “We definitely want to know if a patient feels feverish, especially if it’s something different than how they normally feel,” she says. Dr. Lee adds that it isn’t common for her to see fever as a sign of flare for her patients.

Bottom line: It’s important to know your baseline for everyday symptoms — including pain, stiffness, swelling, fatigue, and fever — once you’ve been diagnosed with inflammatory arthritis. This helps you understand when your aches and pains are normal, and when something is off.

Keep Reading

  • The 4 Stages of RA Disease Progression
  • How Menopause Affects Rheumatoid Arthritis
  • Remission and Low Disease Activity in Rheumatoid Arthritis: What It Actually Means

Is My Joint Pain Caused by Rheumatoid Arthritis (RA) or an Infection?

Joint inflammation and pain can be caused by a bacterial, viral, or fungal infection, and sometimes these symptoms are initially mistaken for rheumatoid arthritis (RA). People who have joint pain and a fever that they suspect is caused by an infection are advised to seek medical attention.

See What Is Rheumatoid Arthritis (RA)?

Viral Arthritis vs. Rheumatoid Arthritis

Experts estimate about 1% of arthritis cases to be viral arthritis.1 In these cases, a viral infection leads to joint pain and swelling. For example, parvovirus B19, known for causing fifth disease (erythema infectiosum), sometimes causes swollen, painful joints and anemia. Other examples of viruses that can cause viral arthritis include enterovirus, rubella, HIV, and hepatitis B and C.

How is it similar to RA? Viral arthritis results in inflamed joints that are swollen, tender, red, and warm to the touch.

How is it different? There is no specific blood test for RA, but a blood test can usually show whether or not a person has or had a particular virus. The joint symptoms will typically go away once the viral infection is either treated or resolves on its own, though in some cases arthritis symptoms become chronic.

See Rheumatoid Arthritis (RA) Symptoms

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Lyme Disease vs. Rheumatoid Arthritis

Lyme disease is a bacterial infection spread to humans by infected deer ticks and western blacklegged ticks. Some people do not know they have been bitten, making diagnosis challenging. A doctor may consider a Lyme disease diagnosis if the patient experienced a bulls-eye shaped rash or has been in area where deer ticks and Lyme disease thrive, such as forested areas of the East Coast and upper Midwest.

See Lyme Disease and Rheumatoid Arthritis (RA) vs. Fibromyalgia

How is it similar to RA? Lyme disease can cause joint pain, fatigue, and a fever.

See Risk Factors for Rheumatoid Arthritis (RA)

How is it different? People with Lyme disease often report headaches and/or stiff necks. Lymph nodes may become swollen and muscles may ache. A fever may be accompanied by the chills.

A blood test can show the presence of Lyme disease, but it cannot be done until 2 or 3 weeks after the tick bite, and results are not always accurate. (A more precise blood test is available, but accurate results require the test be done several weeks after exposure.)

Experts recommend treating suspected Lyme disease with antibiotics as soon as possible, often before lab tests can confirm a diagnosis.

In This Article:

  • Are My Painful Joints Caused By Rheumatoid Arthritis (RA) or Something Else?
  • Is My Joint Pain Rheumatoid Arthritis (RA) or Spondyloarthropathy?
  • Is My Joint Pain Caused By Rheumatoid Arthritis (RA) or a Crystal Arthritis?
  • Is My Joint Pain Caused by Rheumatoid Arthritis (RA) or an Infection?
  • Is My Joint Pain Caused by Rheumatoid Arthritis (RA) or Another Autoimmune Disorder?
  • Rheumatoid Arthritis Overview Video

Septic Arthritis vs. Rheumatoid Arthritis

Sometimes an infection in a joint can cause severe inflammation, pain, and swelling. Most septic arthritis is caused by a bacterium called Staphylococcus aureus (sometimes called a “staph infection”).

Septic arthritis occurs when a bacteria, virus, or fungus elsewhere in the body travels through the blood stream and invades the joint. It can also occur when an infectious organism reaches the joint through a break in the skin (e.g. a cut or eczema rash), though this is less common.

See Psoriatic Arthritis Symptoms

How is it similar to RA? Infectious arthritis results in an inflamed joint that is swollen, tender, red, and warm to the touch. Often just one joint is affected. People with infectious arthritis may also have a fever and/or feel unwell.

How is it different? Joint symptoms usually appear suddenly and are often severe, so that the person cannot use the affected joint. Lab tests can confirm whether or not a joint is infected.

People who have weakened immune systems, including people who take RA medications, are at an increased risk for septic arthritis.

See Rheumatoid Arthritis (RA) Treatment

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The Differences Between Infectious and Reactive Arthritis

Reactive arthritis occurs when the immune system overreacts to an infection, causing it to attack the joints. The organism that caused the original infection—usually a type of bacteria—is not causing the joint symptoms. In fact, the person may be completely recovered from his or her illness and no longer have symptoms from the original infection.

See Reactive Arthritis Survival Guide

In contrast, a person with infectious arthritis has an existing infection and the infectious organism (e.g. bacterium) may be present in the affected joint capsule.

See Infections that Can Cause Reactive Arthritis

Some experts consider reactive arthritis to be a type of infectious arthritis.2

See How Doctors Treat Reactive Arthritis

Infectious Arthritis

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In this Article

  • Basics of Infectious Arthritis
  • Causes of Infectious Arthritis
  • Diagnosis of Infectious Arthritis
  • Treatment of Infectious Arthritis
  • Summary

Basics of Infectious Arthritis

Infectious arthritis is a form of arthritis that is produced by an infection. It is also called “septic arthritis.”

Infections

An infection is an illness that is caused by certain types of germs. There are three major kinds of germs that can cause infections: bacteria, viruses or fungi.

Normally, these germs are not found in a person’s body. They can live in the air in uncooked food, plants, soil, animals or trash. When they enter a person’s body these germs generally cause the person to become sick. Doctors call an illness that is directly caused by any one of these germs an “infection.”

Arthritis

Arthritis means joint inflammation (“arthr-” = joint”; “-itis” = inflammation). There are over 100 kinds of arthritis. How does a person know if he or she has inflammation in a joint or another part of the body? Generally, that area becomes warm, painful, swollen, red and/or stiff.

Prognosis

Unlike other types of arthritis, infectious arthritis is usually not a long-term illness. Treated promptly and properly, it is generally a curable form of arthritis. However, without proper treatment, infectious arthritis can result in serious damage to the joints involved and may spread to other parts of the body. That’s why it is important to recognize the symptoms of infectious arthritis and get prompt treatment.

Anatomy

Infectious arthritis may occur without any other infection present. However, it is usually the result of a previous infection. A germ first causes an infection elsewhere in the body, then spreads to one or more joints to produce infectious arthritis.

A germ can enter through almost any place in a person’s body. The most common places of entry are a person’s skin, throat, ears or nose. Once inside the body, the germs can get into the blood stream. From there they can travel to the person’s joints (or any place that is suitable for them to live). Sometimes a bacterium, virus or fungus can enter a person’s joint directly through a wound.

Most often, only one joint is affected. Sometimes two or three joints become involved. The large joints are most often infected especially the shoulders, hips and knees, although other joints can also become involved.

Sometimes a condition called erythema nodosum can occur along with an infection. Although it is most often associated with tuberculosis and infections by certain fungi, it is not due directly to these infectious germs. The most noticeable symptom of erythema nodosum is red tender bumps about the size of a quarter–in the skin of the lower legs and sometimes on other parts of the body. Other symptoms that may appear include inflammation of the ankle (and sometimes other joints) and fever.

Causes of Infectious Arthritis

Infectious arthritis may be caused by bacteria, viruses or fungi.

Bacteria

Most types of infectious arthritis are caused by bacteria. There are many different kinds of bacteria that produce a variety of infections. Bacteria that can cause infectious arthritis include: gonococcus, certain Gram-positive bacteria, certain Gram-negative bacteria, spirochetes, and tuberculosis. Descriptions of these bacteria and the symptoms they produce are listed below.

Gonococcus

Gonococcus is the name of the bacterium that causes gonorrhea. Gonorrhea is a sexually transmitted disease. It primarily affects the genital area. However the gonococcus bacterium can travel through the blood stream to other parts of the body. If it settles in one or more joints, infectious arthritis can develop in those joints and the area that surrounds the joints. Gonococcus generally affects the knee joints and can also affect the tendons and bursae to cause tendonitis and bursitis.

This infectious arthritis can occur within days or weeks after the symptoms of gonorrhea appear. It occurs more often in women than in men. The symptoms of gonorrhea are not as obvious for women. Therefore, women generally seek treatment later than men. This delay in treatment gives the bacteria more time to travel through the bloodstream.

Symptoms of infectious arthritis caused by gonococcus may include:

  • fever
  • chills
  • abdominal pain in women
  • discharge from the penis or vagina
  • rash which appears as a few red rimmed dime-sized pus filled spots that are raised in the center
  • inflammation of the tendons (bands that connect bones to muscles)
  • arthritis which develops in joints such as the knees or wrists

This type of arthritis should be treated immediately–as soon as you notice symptoms–to prevent serious damage to the joints.

Gonorrhea is spread from person to person by sexual contact. Therefore care should be taken in sexual relationships where there may be a chance of getting the disease. The spread of gonorrhea can usually be prevented by the correct use of condoms. Anyone who thinks he or she may have gonorrhea should see a doctor as soon as possible. Appropriate treatment with antibiotics can prevent damage to joints and other parts of the body.

Gram-positive bacteria

There are several different kinds of Gram-positive bacteria. They are called Gram-positive because when mixed in the laboratory with a solution called “Gram’s stain,” they take on a bluish-purple stain or color. Some of the Gram-positive bacteria that can cause infectious arthritis are: staphylococcus, streptococcus, and pneumococcus.

These Gram-positive bacteria cause other illnesses such as meningitis, pneumonia, or an abscess. Often people with these illnesses develop infectious arthritis when the bacteria spread to a joint and produce inflammation. In other cases, Gram-positive bacteria cause infectious arthritis, but no other illness is detected.

Staphylococcus is the second most common cause of infectious arthritis. It is often called a “staph infection.” A staph infection can occur as a result of a skin or sinus infection or after surgery. People who have rheumatoid arthritis or who take steroids or immunosuppressive agents (such as imuran, cytoxan and methotrexate) are more apt to get infectious arthritis from staphylococcus bacteria.

Symptoms of a “staph infection” in a joint may include:

  • fever
  • redness, swelling, extreme tenderness occurring in a single joint
  • pus (yellowish-white substance) draining from a wound or abscess

Gram-Negative Bacteria

These bacteria are called Gram-negative because they do not take on a bluish-purple color when mixed with the Gram’s stain. They are less likely to produce infectious arthritis than Gram-positive bacteria. Gram-negative bacteria commonly infect people whose bacteria-fighting defense system (immune system) is already weak.

Hemophilus is a Gram-negative bacterium that causes severe sore throat and meningitis. It is a major cause of infectious arthritis in infants but rarely causes it in adults.

Spirochete- Lyme Disease

Spirochetes are bacteria that appear spiral shaped under a microscope. There are many different kinds of spirochetes. One kind (called Borrelia) causes a form of infectious arthritis called Lyme disease. This disease occurs in people as a result of a tick bite. Anyone can get Lyme disease but it is more common in children.

The Borrelia spirochete is carried by a small tick (called Ixodes) that lives on deer and mice. It is found in wooded areas during the spring and early summer. Many areas of the country have reported cases of Lyme disease. However most cases occur in seven states: New York, New Jersey, Rhode Island, Connecticut, Massachusetts, Wisconsin and Minnesota.

People infected may not have seen the tick because it is very tiny. It is oval, has eight legs and is often no larger than a pinhead or match head.

When the tick bites someone, it injects the spirochete into the person’s blood stream. Symptoms of the infection usually do not appear until 1-3 weeks after the bite.

You may want to protect yourself and others from Lyme disease when you visit wooded or lake areas as suggested below.

The following measures may help prevent tick bites:

  • wear long sleeves and pants
  • pull socks over pant legs
  • wear closed shoes
  • wear a hat
  • use tick repellent on clothes
  • shower afterwards and inspect for ticks particularly checking arms, legs and hairline

Symptoms of early Lyme disease include:

  • Skin rash which is 5-20 inches in diameter. It is white in the center and bright red on the outside. The center is hard and hot to touch. It may occur around the bite and on different parts of the body. It may last up to a month.
  • Flu-like symptoms of fever and chills, fatigue, headache, vomiting and soreness all over.
  • Joint pain and swelling usually in the knees and sometimes also in the hips, shoulders and ankles.
  • Sore throat, dry cough, stiff neck, swollen glands.
  • Dizziness and sensitivity to sunlight.

If untreated, the spirochete may spread to the person’s brain, heart and nervous system. This could lead to symptoms such as:

  • temporary paralysis of the face
  • numbness and tingling in the hands or feet
  • severe headaches, depression, memory lapses
  • poor muscle coordination
  • heart problems.

With proper medication, Lyme disease usually goes away in a short time. However, if not diagnosed and treated properly, symptoms can become more severe and recur several times over a year or more.

Tuberculosis Bacteria

The bacterium that causes tuberculosis can also cause infectious arthritis. It is much less common today than it was years ago. When it does occur, it is often very slow to develop and usually spreads from the lung to involve only one joint.

Viruses

Infectious arthritis can also be caused by viruses. It is usually produced by a viral infection that is already present in a person’s body. Infectious hepatitis, mumps and infectious mononucleosis are viral infections that can lead to a short bout of infectious arthritis. Generally, the joint inflammation lasts no more than one to two weeks. German measles can also produce an infectious arthritis which may occasionally last as long as one year after the measles rash is gone.

Fungi

Fungi are the least common cause of infectious arthritis. Arthritis produced by a fungus usually develops very slowly. Types of fungi that can produce arthritis are usually found in soil, bird droppings and certain plants (especially roses). Chicken farmers and gardeners are especially likely to be exposed to this type of arthritis.

Differences between types of infections

Bacterial, viral, and fungal infections are different from each other in the following ways:

Bacterial infection:

  1. Generally located in one place or area
  2. Usually accompanied by fever and shaking chills
  3. Usually begins quite suddenly
  4. Usually cured by taking antibiotics

Viral infection:

  1. Ache all over
  2. Usually mild or no fever
  3. Not cured by antibiotics
  4. Usually goes away on its own

Fungal infection:

  1. May be in one area or throughout the body
  2. May have low-grade fever or none at all
  3. Usually begins quite slowly over weeks or months
  4. Usually treated with anti-fungal medication

Can periodontal surgery cause infectious arthritis?

Any significant manipulation of the gums can cause bacteria to enter the blood stream–even brushing the teeth in the presence of gum disease. Periodontal health is important. In rare cases, periodontal disease may cause an infectious arthritis, especially when extensive dental work is being done. We worry about it in particular for those with artificial joints in place as they can not combat the bacterial that might get into the blood stream. Infectious arthritis occurs more frequently in people with abnormal joints, especially rheumatoid arthritis, people with artificial joints or those with diabetes. For those with arthritis or artificial joints in place, consult your rheumatogist or orthopedist before having dental work done. An antibiotic 1 hour before and 8 hours after may be in order.

Diagnosis of Infectious Arthritis

To determine if a person has infectious arthritis, the doctor will first ask about the person’s symptoms and any other medical conditions.

The doctor will want to know about any recent travel, illness or contact with people who have had infections. Work or home conditions might also give the doctor clues about the illness.

After the medical history, the doctor will do a physical exam and order special tests. X-rays may be taken to determine if there is joint damage. Various laboratory tests can be done to find out if an infection is present.

It is most important to identify the specific germ causing the infection. Bacteria and fungi can usually be identified from joint fluid, blood, urine or the infected area. The doctor will almost always want to remove and examine fluid from the infected joint. If tuberculosis or fungi are suspected, it will be necessary to remove a tiny piece of tissue from the joint. This is called a biopsy. In the laboratory, the fluid or tissue will be examined under the microscope to determine what kind of bacteria or fungi are present.

A viral infection is usually diagnosed by a person’s symptoms and medical history. After the infection has been present for weeks or longer, blood tests may show the presence and amount of a person’s own virus-fighting proteins (antibodies) in response to a viral infection.

Treatment of Infectious Arthritis

Most often people with infectious arthritis need to go into the hospital for diagnosis and treatment; the treatment and length of stay will vary depending on the type of infectious arthritis present.

Treating bacterial infections

Almost all people whose infectious arthritis is caused by bacteria are given an antibiotic. Antibiotics are medications that fight off bacteria. Different antibiotics destroy different bacteria. Therefore, the antibiotic prescribed depends on the type of bacteria present.

Antibiotics can be taken by mouth or given through the person’s vein. When given through a vein it is called an intravenous or IV injection. An IV releases the antibiotic directly into the bloodstream. This allows the infection-fighting drug to travel faster in higher concentration and directly to the infected joint.

Often antibiotics can destroy an infection in a few days or weeks. In some cases, antibiotics must be taken over several months. Remember to take antibiotics for the number of days prescribed–even if symptoms disappear. Many people think they can stop taking the medication when the symptoms are gone. Even though symptoms disappear, bacteria may still be present. If not destroyed by the antibiotic, the bacteria can re-infect the area.

Treating viral infections

Generally, infectious arthritis caused by a virus goes away by itself. Medications are not available to treat viral infections. Resting in bed and drinking plenty of liquids are usually recommended.

Treating fungal infections

Fungal infections are often difficult to treat. Doctors can prescribe a fungus-fighting medication. This may need to be used for months. Surgery is sometimes performed to clean out the infected joint. Fungal infections are difficult to eliminate entirely. Even after successful treatment, they may recur.

Treating inflammation

For all types of infectious arthritis, the doctor may prescribe a medication to relieve pain and inflammation. These are called anti-inflammatory drugs.

In many cases, the doctor may need to drain one or more joints. This is done by inserting a needle into the joint and withdrawing fluid. This procedure is generally easy and usually not painful. It is done to remove any harmful substances released by the bacteria or by the body’s bacteria fighting cells. Joint fluid drainage may need to be done several times. Most of the time, repeated drainage along with high doses of IV antibiotics can prevent the need for surgery.

Other treatments

Arthritis treatment may also include resting and protecting the joints. Splints can be used to limit movement. This helps reduce pain and tissue damage.

After the infection is gone, the doctor will frequently recommend exercises to build up muscle strength. Other exercises may be recommended to increase the joint’s range of motion. A physical therapist can demonstrate and assist with exercises that can be done at home.

Summary of infectious arthritis

  • Infectious arthritis is a form of arthritis that is caused by bacteria, viruses or fungi.
  • Many different types of infections can produce joint inflammation. This type of arthritis is almost always curable.
  • If the infection is diagnosed and treated promptly, there is usually no lasting joint damage. If the infection is not treated early, permanent joint damage may result. Bacterial and fungal infections are usually treated with medication. A viral infection will generally go away on its own.
  • Most often people with infectious arthritis are able to resume their normal activities once the infection is gone.

Credits

Some of this material may also be available in an Arthritis Foundation brochure.

Adapted from the pamphlet originally prepared for the Arthritis Foundation by Frank R. Schmid MD. This material is protected by copyright.

Rheumatoid Arthritis Fever: Dealing With the Flu-Like Symptom

Dealing With RA Fever

“A fever is a good thing,” Torres says. “It means you have a good immune system that fights infection.” Here are some tips you can try the next time you have an RA fever:

  • When you feel feverish, Torres recommends resting and placing a cold compress on your forehead for a natural remedy.
  • If you’re out in public, you can downplay flushed cheeks by staying hydrated and not pushing yourself.
  • Rheumatoid arthritis fevers should be treated with fever medication like any other fever. “Take an over-the-counter, anti-inflammatory medication that treats fever, such as ibuprofen or acetaminophen,” Torres recommends.

RA Fever: Kelly’s Story

Kelly Young, creator of Rheumatoid Arthritis Warrior and founder of the Rheumatoid Patient Foundation, was diagnosed with rheumatoid arthritis in 2006 and experienced frequent low-grade fevers on a regular basis for many years. Young’s RA symptoms have not responded to non-steroid treatment and, when she has a fever caused by RA, it doesn’t respond to normal fever medication either.

“I do what most rheumatoid patients do with fever — the same thing we do with pain: We build up a tolerance so we usually ignore it,” she says. Young routinely takes a non-steroidal anti-inflammatory drug, or NSAID, for pain, but her fever is not diminished even if she takes four ibuprofen (Advil, Motrin). “I’m not sure treating it is possible as a symptom,” she says. “If you respond to disease treatments, then a lot of flares can be reduced, but I have never responded to a non-steroid treatment.”

Even when she uses ice packs for rheumatoid arthritis pain in her neck, the fever lingers. For people whose symptoms are not responsive to treatment, the same fever that would be reduced by NSAIDs if you had a virus is not reduced when it’s caused by RA inflammation, she says.

Young’s personal experience with fever, and similar stories she’s heard from people who visit her site, RAWarrior.com, have led her to believe that rheumatoid arthritis fever should be tracked and used as a form of objective measure of inflammation. “It’s an important symptom that often is not monitored,” she notes.

Fever is a hot button issue within the RA community, she adds, “Anytime I blog about fever, the post gets lots of comments.”

When to Ask Your Doctor About Low-Grade Fever

Although low-grade fever is a common rheumatoid arthritis symptom, you may want to talk to your doctor if rheumatoid arthritis fevers do not respond to over-the-counter medications or natural remedies like cold compresses, because it could be something more serious like an infection.

Don’t ignore joint pain with fever, fatigue: It can mean rheumatoid arthritis

By Dr Chethana D
Joint and back pain, one of the most common ailments, can disable people if the symptoms become chronic. Arthritis has a big impact on the lives of millions of people worldwide. It affects them physically, emotionally and socially as well. It is important to diagnose and treat the condition before arthritis takes the upper hand.
Arthritis & Its Types
Arthritis means joint inflammation, causing pain and stiffness.
The most common type of arthritis is osteoarthritis which occurs due to wear and tear of joints. It commonly affects knees, hips and lower back.
Getty Images
The other type of arthritis is inflammatory arthritis, which comes under the purview of a rheumatologist. This group includes rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and many more.
Rheumatoid arthritis, an autoimmune disease, tends to affect women more than men, primarily in the age group of 30-60 years. Genetic, environmental factors and smoking can lead to developing this condition. About 1 in 100 people are affected by rheumatoid arthritis in India.
Symptoms
The symptoms of rheumatoid arthritis include pain in multiple joints, especially hands, wrists, feet and knees lasting for more than 4 to 6 weeks. There may be swelling in the joints, and severe joint stiffness early in the morning.
Fatigue and feverishness are common signs during the condition.

Treatment
Treatment should be initiated under the guidance of a rheumatologist within 6 to 8 weeks of the onset of symptoms.
The treatment is usually long-term, and includes medications called disease-modifying anti-rheumatic drugs. The medication may include simple pain-killers or a short course of steroids during the initial stages.
For people with very severe arthritis, biologic drugs can be given in the form of tablets, injections or through intravenous route. Novel targeted treatment can halt joint destruction. Apart from medications, adapting to lifestyle changes like working out regularly, quitting smoking, eating healthy and maintaining an ideal weight are important.
The treatment options for people suffering with rheumatoid arthritis are improving everyday with new and more effective medications. It is possible to lead a normal and active life by taking regular medications, and making necessary lifestyle changes. The key is to start treatment early and take it regularly.
(The author is Consultant-Rheumatology at Aster CMI Hospital)

World No Tobacco Day: Smoking Can Hurt Eyes, Bones And Brain

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Thrill Kills

31 May, 2018Most smokers believe smoking is cool. No matter how you indulge in it, tobacco is harmful to your health. Tobacco contains over 7,000 toxins and 70 known carcinogens (chemicals that increase cancer risk) and can damage nearly every organ of the body. Dr Sachin Kumar, Senior Consultant – Pulmonology at Sakra World Hospital explains how smoking affects every part of your body. The next time you are tempted to take a drag, just pause for a minute and think of the consequences of your indulgence.

Symptoms, Diagnosis, & Treatment

Symptoms

  • Most people infected with chikungunya virus will develop some symptoms.
  • Symptoms usually begin 3–7 days after being bitten by an infected mosquito.
  • The most common symptoms are fever and joint pain.
  • Other symptoms may include headache, muscle pain, joint swelling, or rash.
  • Chikungunya disease does not often result in death, but the symptoms can be severe and disabling.
  • Most patients feel better within a week. In some people, the joint pain may persist for months.
  • People at risk for more severe disease include newborns infected around the time of birth, older adults (≥65 years), and people with medical conditions such as high blood pressure, diabetes, or heart disease.
  • Once a person has been infected, he or she is likely to be protected from future infections.

Diagnosis

  • The symptoms of chikungunya are similar to those of dengue and Zika, diseases spread by the same mosquitoes that transmit chikungunya.
  • See your healthcare provider if you develop the symptoms described above and have visited an area where chikungunya is found.
  • If you have recently traveled, tell your healthcare provider when and where you traveled.
  • Your healthcare provider may order blood tests to look for chikungunya or other similar viruses like dengue and Zika.

Treatment

  • There is no vaccine to prevent or medicine to treat chikungunya virus.
  • Treat the symptoms:
    • Get plenty of rest.
    • Drink fluids to prevent dehydration.
    • Take medicine such as acetaminophen (Tylenol®) or paracetamol to reduce fever and pain.
    • Do not take aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS until dengue can be ruled out to reduce the risk of bleeding).
    • If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.
  • If you have chikungunya, prevent mosquito bites for the first week of your illness.
    • During the first week of infection, chikungunya virus can be found in the blood and passed from an infected person to a mosquito through mosquito bites.
    • An infected mosquito can then spread the virus to other people.

More detailed information can be found on CDC’s chikungunya web page for healthcare providers

Rheumatoid Arthritis Fevers: Why They Occur and What to Do About Them

A normally functioning immune system can tell the difference between “attackers,” such as germs or viruses, and healthy cells. When the body is attacked by illness, the immune system fights back. But when autoimmune dysfunction occurs, the immune system mistakes healthy cells for invaders, and attacks them instead. In someone with RA, this causes inflammation of the tissue around the joints. RA can also affect the eyes, lungs, skin, and heart.

Inflammation is a normal part of the immune response. However, inflammation from RA is part of the problem. It causes considerable pain, damage to joints, and reduced mobility. The same substances that cause inflammation of the joints can also cause a fever. While inflammation of the joints can be severe enough to cause a fever, it is important to remember that an infection is a real possibility. RA also causes an increase in metabolic rate, which can also result in a fever.

Normal body temperature ranges from 97°F to 99°F. Fevers under 101°F are not considered serious in adults and are also not uncommon in RA patients.

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