Diagnosis of Acute Rheumatic Fever in an 8-Year-Old Child: A Case Report

Abstrak

Abstract: Acute Rheumatic Fever (ARF) is a serious autoimmune disease caused by a Group A Streptococcus (GAS) infection. In genetically susceptible people, the immune system mistakenly attacks its own tissues, a process called molecular mimicry. This can lead to inflammation of the joints and permanent heart valve damage, known as Rheumatic Heart Disease (RHD). Diagnosing ARF is challenging as symptoms are varied and there is no single test. A diagnosis relies on the Jones Criteria, which combine clinical signs with evidence of a prior GAS infection.

Case Illustration : An 8-year-old boy presented with migratory arthritis in his hands and feet, following a week of a sore throat and intermittent fever. Residing in a densely populated area, the patient had an environmental risk factor for bacterial spread. Lab tests confirmed a preceding Streptococcus infection with an elevated anti-streptolysin O (ASTO) titer of 800 IU/mL and a C-Reactive Protein (CRP) level of 41 mg/L. The diagnosis of Acute Rheumatic Fever was established, as the patient met one major criterion (arthritis) and two minor criteria (fever and elevated CRP) based on the Jones Criteria.

Conclusion : An 8-year-old boy was diagnosed with Acute Rheumatic Fever (ARF), an autoimmune disease triggered by a Group A beta-hemolytic Streptococcus infection. The main symptoms were migratory arthritis and intermittent fever, preceded by a sore throat. The diagnosis was confirmed using the Jones Criteria, as the patient met one major criterion (arthritis) and two minor criteria (fever and elevated C-Reactive Protein or CRP). Evidence of the prior infection was supported by an increased anti-streptolysin O (ASTO) titer of 800 IU/mL.