Rheumatic fever is a complication of strep throat caused by infection with group A Streptococcus bacteria. This disease can affect anyone, especially children aged 5-15 years because the immune system mistakes healthy tissue as an enemy.
This disease can affect the heart, joints, brain, and skin. Rheumatic fever can develop if strep throat and scarlet fever infections are not treated properly. Early diagnosis and treatment with antibiotics are key to preventing rheumatic fever.
If left untreated, rheumatic fever can cause serious complications, especially to the heart. Rheumatic fever is usually treated with anti-inflammatory drugs or corticosteroids, depending on the severity of the symptoms.
Symptoms of Rheumatic Fever
Rheumatic fever symptoms are generally felt 2 to 4 weeks after untreated sore throat due to group A Streptococcus bacterial infection. The symptoms themselves vary.
The following are symptoms of rheumatic fever which is caused by inflammation of the heart, joints, skin, or central nervous system:
- Fever. Usually, the body temperature increases accompanied by fatigue and malaise.
- Joint pain. Commonly experienced in the knee, ankle, elbow, and wrist joints.
- Pain in one joint that moves to another joint.
- The joint becomes red, feels hot, or swells.
- A small, painless lump appears under the skin.
- Pain in the chest.
- Noise in the heart organ.
- Fatigue,
- A flat, painless rash with uneven edges on the skin.
- Jerky, uncontrolled body movements. This condition is most often experienced in the hands, feet, and face.
- Engaging in unusual behavior, such as crying or laughing out loud.
Causes of Rheumatic Fever
Rheumatic fever can occur as a complication of untreated sore throat caused by infection with group A Streptococcus bacteria . When the body is infected by bacteria, the immune system will produce antibodies to fight the bacteria that enter.
However, in the body of the sufferer, antibodies actually attack healthy body tissues, especially the heart, joints, skin, brain, and spine. This condition is thought to occur due to the similarity between the proteins in Streptococcus group A bacteria and proteins in body tissues. This causes the immune system to wrongly recognize body tissues as dangerous enemies.
Rheumatic Fever Risk Factors
Several factors that can increase the likelihood of developing rheumatic fever include:
- Family history. Some people carry genes that may make them more susceptible to developing the disease.
- Types of Streptococcus bacteria. Certain strains of Streptococcus bacteria are more likely to contribute to rheumatic fever than others.
- Environmental factors. The risk of disease is greater for someone who lives in a densely populated environment, has poor sanitation, and other conditions that increase transmission or repeated exposure to Streptococcus bacteria.
Diagnosis of Rheumatic Fever
The doctor will diagnose the disease with a complete medical interview and a thorough physical examination. In addition, supporting examinations may also be needed to help the doctor diagnose rheumatic fever. Here are some supporting examinations:
- ASTO test , which is a blood test to measure the levels of antibodies against streptolysin O, a substance produced by group A Streptococcus bacteria.
- Electrodiagram (ECG) or heart recording, which aims to assess the presence of heart rhythm disturbances.
- Echocardiography (heart ultrasound), which aims to see if the heart is functioning properly in pumping blood.
Complications of Rheumatic Fever
The inflammation caused by rheumatic fever can last from a few weeks to a few months. In some cases, the inflammation causes long-term complications, such as permanent damage to the heart (rheumatic heart disease).
The condition usually occurs 10 to 20 years after the original disease. In severe cases, the disease can cause damage to the heart valves while the child still has symptoms. The most common problem occurs in the valve between the two left chambers of the heart (the mitral valve).
Such damage may result in:
- Narrowing of the valves, which can reduce blood flow throughout the body.
- A leak in the valve, which causes blood to flow in the wrong direction.
- Heart muscle damage, which can weaken the heart muscle, affecting its ability to pump blood.
Damage to the mitral valve, other heart valves, or other heart tissue can lead to heart problems later in life. These include atrial fibrillation, or irregular heartbeat, and heart failure.
Rheumatic Fever Treatment
The goal of rheumatic fever treatment is to relieve symptoms and prevent recurrence of the disease. Some of the medications that doctors will prescribe include:
1. Antibiotics
The antibiotics commonly prescribed by doctors are from the penicillin group and are given by intravenous injection. Penicillin will be given every 28 days, for at least 10 years or until the child is 21 years old. If the child has heart valve damage, penicillin injections will be given for a longer period of time.
Avoid stopping this medication without your doctor’s approval, as it can cause a recurrence of rheumatic fever and more extensive and severe damage to the heart valves.
2. Anti-inflammatory
Common anti-inflammatory drugs prescribed by doctors are from the non-steroidal anti-inflammatory group, such as aspirin or ibuprofen. These drugs are given to relieve fever, pain, and inflammation. If symptoms do not improve with the administration of non-steroidal anti-inflammatory drugs, the doctor can prescribe drugs from the corticosteroid group.
3. Anticonvulsants
These anticonvulsant drugs can be given if the sufferer experiences seizures. Anticonvulsant drugs that can be given include carbamazepine or valproic acid.
If the fever does not improve, treat it by taking fever-reducing medication.
4. Symptomatic treatment
Usually, the doctor will give medication to treat other symptoms, such as fever-reducing medication or medication for nausea according to the patient’s needs. In the context of rheumatic fever, symptomatic treatment focuses on reducing discomfort and improving the patient’s quality of life.
Rheumatic Fever Prevention
Having had a group A Streptococcus infection before is no guarantee that someone will not be infected again in the future. A person is at risk of getting rheumatic fever more than once. However, there are things that can be done to protect yourself from group A Streptococcus infections.
Here are some preventive measures that can be taken:
- Get used to washing your hands with running water and soap.
- Wear a mask when traveling outside the home and interacting with people with influenza or sore throats.
- Do not share eating and drinking utensils with other people.
