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Acute rheumatic fever is a nonsuppurative, immune-mediated consequence of group A streptococcal pharyngitis. Recurrent or severe acute rheumatic fever can cause permanent cardiac valve damage and rheumatic heart disease. Universally, the most common major manifestations during the first episode of ARF remain carditis and arthritis. Subclinical carditis now can fulfils a major criterion for ARF in all populations as in revised Jones criteria – AHA 2015. Many of the clinical features of ARF are non-specific, so a wide range of differential diagnoses should be considered. Primary prevention requires accurate recognition and proper antibiotic treatment of GAS pharyngitis. Prevention of recurrent attacks of rheumatic fever (secondary prevention) is the most cost-effective way of preventing further rheumatic heart disease (RHD). Penicillin remains the antibiotic of choice. Intramuscular penicillin is preferred as it is more effective than oral penicillin and results in better compliance.

Malaria is an infectious disease with worldwide distribution. The symptom ranges from asymptomatic to severe malaria that could cause mortality. Sequestration and rosetting in the capillaries of several organs in combination with the host inflammatory and immune response could cause multi-organ dysfunction including brain, liver, lung, kidney, etc. This review is to summarize the clinical and histopathological aspect of the disease, especially in lung, liver, and kidney. The clinical importance of severe malaria in the lung are acute lung injury or acute respiratory distress syndrome, jaundice in the liver, and acute kidney injury in the kidney. The histopathological change, in general, is the sequestration of infected erythrocytes in the capillaries of the organ. In the lung, the main changes are seen especially the septa. While in the liver, there are various changes including Kupffer cells hyperplasia, the proliferation of portal tract and bile duct, etc. In the kidney, the changes are in the glomerulus, tubules, and interstitial.

Abstract Malaria is a parasitic infectious disease caused by Plasmodium, which remains a world health problem with an estimated 219 million cases worldwide. In severe malaria infection, several organs of the body can be affected, including the kidneys. One of the pathophysiology associated with the worsening of this disease is oxidative stress. The use of antioxidants is expected to prevent this, and one product that has a high antioxidant content is virgin coconut oil (VCO). This study aimed to analyze the effect of VCO on the kidney in Plasmodium berghei ANKA-infected mice. This study was an in vivo laboratory experimental study with a randomized post-test only control group design using 35 BALB/c mice infected with P. berghei ANKA, weighing 20-30 grams. VCO with the Javara® brand is used with doses of 1, 5, and 10 ml/kg body weight (kgBW)/ day. The parameter assessed were levels of BUN, creatinine, and renal histopathological changes. The administration of VCO on the treated group shows minimal tubular necrosis and glomerulonephritis compared to the negative control group. The BUN and creatinine levels in the treated group were also lower than the negative control group. The results showed that VCO has a nephroprotective effect against P. berghei ANKA infection in mice. Keywords: malaria, kidney, virgin coconut oil