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.
If left untreated, rheumatic fever can cause permanent damage to the heart valves and lead to heart failure. Treatment of this disease aims to relieve symptoms, minimize complications, and prevent recurrence of rheumatic fever.
Causes of Rheumatic Fever
Rheumatic fever occurs due to sore throat that is not treated. However, only strep throat caused by infection with the type A Streptococcus bacteria 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 against healthy body tissues, especially in 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 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 rheumatic fever, they are:
- Living in a densely populated environment with poor hygiene
- Have a genetic disorder that is passed down 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 Streptococcus bacterial infection is not treated. Patients with rheumatic fever may experience the following symptoms:
- Weak and easily tired
- Swollen, red, and painful joints, especially in the elbows, knees, and wrists and feet
- Joint pain that radiates 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 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 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:
- Throat feels very painful all of a sudden
- 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
- High fever over 38.3 celcius
- Difficult to breathe
Rheumatic Fever Treatment
Treatment of rheumatic fever aims to relieve symptoms and prevent recurrence. The method of treatment is by administering drugs, such as:
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 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 rheumatic fever to recur. As a result, heart valve damage will be more severe.
Meanwhile, in patients who are allergic to penicillin, doctors can give an antibiotic type erythromycin.
Your doctor will give you 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 corticosteroids.
Carbamazepine or valproic acid is 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 develops rheumatic fever. The 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 that 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 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
- Wearing a mask when around people who are sick with a cough, runny nose or sore throat
- Always keep your house and surroundings clean