Jorianto Muntari - Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Faridin Pango - Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Idar Mappangara - Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Diza Khairina Mukhlisah - Department of Cardiology and Vascular Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Rizalinda Sjahril - Department of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia

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 ۳۹-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 ۳/۶ systolic murmur at apex. Laboratory results were Hb ۹.۴ g/dl, ESR I: ۶۱ mm, ESR II: ۱۵۹ mm, ASTO ۲۵۶۳ IU/ml, and CRP ۸.۹ mg/l. Results of Transthoracic echocardiography revealed vegetation on the posterior mitral leaflet measuring ۲.۰۹ x ۰.۷ and blood culture identified Streptococcus alactolyticus. Conclusion: Patients diagnosed with recurrent rheumatic fever and infective endocarditis received empirical antibiotic therapy for ۲ weeks and corticosteroids, after follow-up the patient experienced clinical improvement and echocardiography showed reduced vegetation size.

Recurrent Rheumatic Fever, Prolonged Fever, Infected Endocarditis, تب روماتیسمی مکرر, تب طولانی مدت, اندوکاردیت عفونی