An Adult Woman Diagnosed with Recurrent Rheumatic Fever and Infective Endocarditis with Manifestations of Prolonged Fever and Heart Murmur

Background and Aim: Rheumatic Fever (RF) is a non-suppurative systemic inflammatory disease with a delayed autoimmune caused by Group A streptococcal infections. Inadequate RF treatment causes recurrent RF which is a predisposing factor for Infective Endocarditis. Case Presentation: A 39-year-old woman was admitted to the hospital with chief complaints of intermittent fever since one month ago, shortness of breath during strenuous activities, weight loss, and easy fatigue. Heart examination palpable thrill, grade 3/6 systolic murmur at apex. Laboratory results were Hb 9.4 g/dl, ESR I: 61 mm, ESR II: 159 mm, ASTO 2563 IU/ml, and CRP 8.9 mg/l. Results of Transthoracic echocardiography revealed vegetation on the posterior mitral leaflet measuring 2.09 x 0.7 and blood culture identified Streptococcus alactolyticus. Conclusion: Patients diagnosed with recurrent rheumatic fever and infective endocarditis received empirical antibiotic therapy for 2 weeks and corticosteroids, after follow-up the patient experienced clinical improvement and echocardiography showed reduced vegetation size.