Rheumatic fever - Symptoms, causes and treatment

Rheumatic fever is an inflammatory disease, which is Complications of strep throat consequence bacterial infection Streptococcus. Although it can be experienced by anyone, rheumatic fever tends to attack children aged 5 to 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 bacterial infections Streptococcus through splashes of saliva when coughing or sneezing.

Apart from complications from infection Streptococcus In the throat, rheumatic fever can also occur as a complication of scarlet fever, which is caused by the same bacteria.

Rheumatic fever can cause permanent damage to the heart valves and even heart failure, if left untreated. The treatment given aims to relieve symptoms, minimize complications, and prevent the recurrence of rheumatic fever.

Symptoms of Rheumatic Fever

Symptoms of rheumatic fever often appear 2-4 weeks after strep throat due to bacterial infection Streptococcus which is not handled. Patients with rheumatic fever may experience the following symptoms:

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

When to go to the doctor

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

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

  • Throat suddenly feels very painful
  • Difficult to swallow
  • Swollen and red tonsils
  • There is pus in the tonsils
  • Red rash appears on the skin
  • Swollen lymph nodes in neck
  • No cough and cold

If the above symptoms occur, or if sore throat does not improve within 2 days and is accompanied by fever, difficulty breathing, or difficulty swallowing, consult a doctor immediately.

Causes of Rheumatic Fever

Rheumatic fever can occur if strep throat is left untreated. However, not all strep throat will cause rheumatic fever, but only strep throat caused by a bacterial infection Streptococcus type A.

When the body is infected with bacteria, the immune system will produce antibodies to fight the incoming bacteria. However, in people with rheumatic fever, these antibodies turn against healthy body tissues, especially the heart, joints, skin, brain, and spine.

It is not 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 bacteria Streptococcus with proteins in body tissues. As a result, the immune system perceives body tissues as harmful organisms.

Risk Factors for Rheumatic Fever

In addition to being triggered by a bacterial infection, there are several factors that are thought to increase the risk of rheumatic fever, namely:

  • Living in a densely populated neighborhood with poor hygiene.
  • Have a genetic disorder that is passed down from parents.
  • 5 to 15 years old.

Rheumatic Fever Diagnosis

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

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

There is no specific test to diagnose rheumatic fever. To confirm the diagnosis of this disease, the doctor will perform a series of additional tests, such as:

  • Examination of blood samples to check for the presence of antibodies to bacteria Streptococcus.
  • Electrodiogram (EKG) to detect heart rhythm disturbances.
  • Cardiac echo (echocardiography) to see abnormalities in the heart.

Rheumatic Fever Treatment

Treatment of rheumatic fever aims to relieve symptoms and prevent disease recurrence. The method of treatment used is by administering the following drugs:

Antibiotic drug

The doctor will inject the antibiotic penicillin 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 10 years or until the child is 21 years old. If the child has damage to the heart valves, penicillin injections will be given for a longer time.

Do not stop treatment with this injectable penicillin without first discussing it with your doctor, because it can cause rheumatic fever to recur. As a result, heart valve damage will be more severe.

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Aspirin or ibuprofen are useful for 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 corticosteroids.


Carbamazepine or valproic acid given to patients who have seizures.

Complications of Rheumatic Fever

Rheumatic fever can last for months to years. In some people, 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 experiences 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.
  • Leaking heart valves, so blood flows in the wrong direction.
  • Damage to the heart muscle, which reduces the heart's ability to pump blood. This condition can lead to heart failure.
  • Inflammation of the inner lining of the heart wall or endocarditis.

Rheumatic Fever Prevention

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

  • Wash your hands regularly with running water and soap.
  • Do not share eating and drinking utensils with others.
  • Wear a mask when you are near people who are sick with a cough, runny nose or sore throat.