Rheumatic Fever

Rheumatic Fever

Rheumatic fever is an inflammatory disease caused by strep throat caused by infection with the Streptococcus type A bacteria. Although it can happen to anyone, rheumatic fever tends to attack children aged 5-15 years.

Although it is caused by a bacterial infection, rheumatic fever does not spread to other people. However, people with strep throat can transmit Streptococcus bacterial infection through splashes of saliva when coughing or sneezing.

Apart from strep throat, Streptococcus bacteria can also cause scarlet fever. In other words, rheumatic fever can also occur due to untreated scarlet fever .

If left untreated, rheumatic fever can cause permanent damage to heart valves up to heart failure. Treatment of this disease aims to relieve symptoms, minimize complications, and prevent rheumatic fever from recurring.

Causes of Rheumatic Fever

Rheumatic fever occurs as a result of strep throat that is not treated. However, only strep throat caused by a type A Streptococcus bacterial infection causes rheumatic fever.

When the body is infected with bacteria, the immune system will produce antibodies to fight the bacteria that entered earlier. In people with rheumatic fever, these antibodies turn to attack healthy body tissue, especially in the heart, joints, skin, brain and spine.

It is not yet known why the immune system in people with rheumatic fever attacks the body itself. However, this condition is thought to occur due to the similarity of proteins in Streptococcus bacteria with proteins in body tissues. As a result, the immune system perceives body tissues as harmful organisms.

risk factors for rheumatic fever

There are several factors that are thought to increase the risk of developing rheumatic fever, namely:

  • Living in a densely populated environment with poor hygiene
  • Have a genetic disorder inherited from parents
  • 5 to 15 years old

Symptoms of Rheumatic Fever

Symptoms of rheumatic fever often appear 2–4 weeks after strep throat due to an untreated Streptococcus bacterial infection . Patients with rheumatic fever may experience the following symptoms:

  • Fever
  • Weak and easily tired
  • Swollen, red, and painful joints, especially in the elbows, knees, and wrists and feet
  • Joint pain that spreads to other joints
  • Red rash on the skin
  • Chest pain
  • Hard to breathe
  • Heart beat
  • Behavioral disturbances, such as crying or laughing suddenly
  • Uncontrolled body movements of the face, hands and feet

When to see a doctor

Sore throats are mostly caused by viral infections . Even so, you still have to be aware of the possibility that your sore throat is caused by a Streptococcus bacterial infection .

Therefore, you should see a doctor if you experience a sore throat due to inflammation, especially if it is accompanied by the following complaints:

  • The throat feels very sore all of a sudden
  • Difficult to swallow
  • Swollen and red tonsils
  • There is pus in the tonsils
  • A red rash appears on the skin
  • Swollen lymph nodes in neck
  • No cough and cold
  • High fever temperature over 38.3 o C
  • Difficult to breathe

Diagnosis of Rheumatic Fever

To determine whether a child has rheumatic fever, the doctor will carry out a physical examination, namely by:

  • Check if there are rashes and lumps on the patient's body
  • Listening to the patient's heartbeat using a stethoscope
  • Check for signs of inflammation in the joints
  • Do a neurological exam

To confirm the diagnosis, the doctor will perform a series of additional tests, such as:

  • Blood tests to check for the presence of antibodies to Streptococcus bacteria
  • Electrodiogram (ECG) to detect heart rhythm disturbances
  • Echocardiography to see abnormalities in the heart

Rheumatic Fever Treatment

Treatment of rheumatic fever aims to relieve symptoms and prevent recurrence. The method of treatment is by administering drugs, such as:

Antibiotic drug

The doctor will inject penicillin antibiotics to kill all the bacteria in the patient's body and prevent rheumatic fever from recurring. Penicillin is given every 28 days, for at least 5 years or until the child is 21 years old.

In patients with heart valve damage, penicillin will be given for 10 years or more.

It is important to remember, do not stop treatment with injectable penicillin without first consulting a doctor, because it can cause a relapse of rheumatic fever. As a result, heart valve damage will be more severe.

Meanwhile, in patients who are allergic to penicillin, doctors can give erythromycin type antibiotics .

Anti- inflammatory drug

The doctor will give paracetamol or ibuprofen to treat fever, pain and inflammation. If the patient does not respond to anti-inflammatory drugs or if the symptoms are severe enough, the doctor will prescribe a corticosteroid class of drugs .


Carbamazepine or valproic acid is given to patients who have seizures.

Rheumatic Fever Complications

Rheumatic fever can last for months to years. In some patients, rheumatic fever can cause long-term complications, such as rheumatic heart disease or permanent damage to the heart.

Rheumatic heart disease can occur 10-20 years after the patient has rheumatic fever. Heart damage in rheumatic heart disease can trigger the following conditions:

  • Narrowing of the heart valves thereby reducing blood flow to the heart
  • Leaky heart valves causing blood to flow in the wrong direction
  • Damage to the heart muscle reduces the heart's ability to pump blood, which can lead to heart failure .

Rheumatic Fever Prevention

How to prevent rheumatic fever is to prevent sore throat. Some preventative steps that can be taken are:

  • Wash your hands regularly with running water and soap
  • Do not share cutlery and drink with other people
  • Wearing a mask when you are near people who are sick with a cough, runny nose or sore throat
  • Always keep your house and surroundings clean
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