Scarlet fever – symptoms, diagnosis. Treatment of scarlet fever in children, adults and pregnant women

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Scarlet fever, or scarlet fever, is one of the acute childhood rash infectious diseases that occurs all over the world. It usually appears in the fall and winter season. It is distributed by droplets. Scarlet fever, despite the widespread use of drugs, is still a fear for parents whose children contracted it.

The disease causes toxic symptoms, and in its late stage it can even develop immune disorders. The bacteria that cause this disease are usually transmitted by airborne droplets and through objects that the sick person has had contact with.

1. Find out how viruses spread

Scarlet fever can also appear as a result of a child’s contact with people who have streptococcal streptococcal strep throat.

It is worth checking if your child is infected with streptococcus by performing the Child health check – diagnostic tests package. This test will also help determine other parameters important for the proper functioning of the children’s body. You can buy the package on Medonet Market.

The first symptoms of scarlet fever are a sore throat, a high temperature and a white coated tongue. Currently, scarlet fever is quite rare, and in our country about 100 cases of the disease are recorded every year for 150 inhabitants.

Scarlet fever can be a very dangerous disease, especially as there is no effective vaccine. Although scarlet fever gives some immunity, there may be relapses because scarlet fever is caused by several types of streptococcus.

Scarlet fever – contagion

Scarlet fever is a consequence of infection with group A β-hemolytic streptococcus – Streptococcus pyogenesor more precisely, the action of type A, B or C erythogenic toxins which are produced by these bacteria.

Classic scarlet fever will only develop in people who are sensitive to the effects of toxins, i.e. have no immunity against them.

Scarlet fever in children

Scarlet fever in children is usually observed in preschool and school age, with the highest peak incidence mainly in fall, winter and early spring. It is not uncommon to hear about local epidemics taking place in kindergartens and schools. Scarlet fever is not observed in infants up to 6 months of age as they are passive immunity due to the maternal transmission of specific antibodies during pregnancy.

The source of the bacteria is usually people suffering from scarlet fever or streptococcal angina, but also those healthy, who are also carriers of group A streptococci. According to epidemiological data, the population is approximately 10-20% of carriers.

Bacteria are usually transmitted by airborne droplets, but infection can also occur through the clothing and equipment used by patients.

Scarlet fever in adults

Although scarlet fever is a disease that is characteristic of childhood, it can also affect adults. As in toddlers, it is caused by group A streptococcal infection. Symptoms of scarlet fever in adults are usually more severe than in children. Adults most often complain of:

1. nausea and vomiting 
2. sharp abdominal pain, 
3. high temperature reaching even 39-40 degrees, 
4. general weakness 
5. enlargement of the tonsils (with a white coating), 
6. a rash on the trunk and limbs 
7. enlarged lymph nodes in the neck area, 
8. gray coating on the tongue, sometimes turning raspberry in color. 

Not all of the symptoms listed are always present. They can occur simultaneously and they can be successive. Given that scarlet fever causes a wide variety of symptoms, there are sometimes diagnostic problems. The symptoms often resemble an allergic reaction, especially when the rash is severe.

Sometimes the disease can be septic. Then the patient develops changes in the throat, along with necrosis of the floor of the mouth and sepsis.

Scarlet fever can pass by itself, so it is important to watch for characteristic symptoms, including a developing rash.

1. Find out more: Infectious diseases during pregnancy

If scarlet fever develops in the family of a pregnant woman, she should avoid contact with her, which may be difficult for a son or daughter. However, it is worth taking all precautions (hygiene is very important) so as not to get infected with scarlet fever.

Scarlet fever – characteristic symptoms

The most common symptoms of scarlet fever include:

1. the onset of scarlet fever is violent, accompanied by a sore throat, coughing, vomiting, high fever, headaches and a markedly increased heart rate; 
2. the occurrence of changes in the throat is also observed: enlarged vivid red tonsils; draped tongue – on the fourth day the characteristic raspberry color of the tongue; 
3. on day 2-3 of scarlet fever, a characteristic, fine-blotched rash begins to appear – the changes appear as if they were pricked by a pin or a wire brush; at first, the rash may be seen in the armpits and groin, then extends over the entire body, except in the oro-mental region (free triangle between the cheek folds – the so-called Filatov’s triangle); after a few days the rash begins to gradually disappear, and after 2 weeks, a characteristic flaky peeling of the skin on the soles of the feet and palms is observed. In adults, the rash can form raised skin lesions, which is why doctors often suggest an allergy. Then the factor indicating scarlet fever is erythema on the face; 
4. Other symptoms of scarlet fever are the tongue covered in white, which transforms into shiny red dots after a few days (this state is referred to as “raspberry language”). In addition, people suffering from scarlet fever also experience enlargement and pain in the cervical and inguinal lymph nodes. 

Acute scarlet fever is characterized by much more serious symptoms. Not rarely, scarlet fever causes cardiovascular disorders and inflammation of the heart muscle. There is also an enlargement of the spleen and liver. Severe changes in the throat can even lead to tissue necrosis in the floor of the mouth.

Scarlet fever – rash

The characteristic symptom of scarlet fever is a rash that appears about three days after the onset of fever. Small dots appear on the patient’s skin, comparable to the size of a pinhead. The rash merges under the knees, on the torso, and in the crease of the elbows and may be itchy.

The skin lesions associated with scarlet fever are most visible on the abdomen, in the groin area and on the breasts. It ranges in color from light pink to red. For scarlet fever, the so-called the violet triangle, which is the area of ​​pale skin around the mouth and nose. Once the rash has cleared, the skin begins to peel – from the face, through the trunk, to the hands and feet.

Scarlet fever – diagnosis

Scarlet fever is diagnosed on the basis of the characteristic clinical picture of the disease and, additionally, group A streptococci can be detected in throat swabs by means of rapid tests performed directly at the patient’s side. Laboratory tests show: in morphology, an increased number of white blood cells and an increase in eosinophils, an increase in ESR and ASO.

Scarlet fever should be differentiated from the following diseases:

1. Kawasaki disease,
2. measles,
3. rubella,
4. staphylococcal infection,
5. toxic shock syndrome.

Scarlet fever – complications

Currently, symptoms of scarlet fever are rarely observed, and if they do occur, the most common are:

1. ulcerative tonsillitis;
2. purulent inflammation of the lymph nodes;
3. otitis media;
4. purulent inflammation of the paranasal sinuses;
5. toxic myocarditis;
6. acute glomerulonephritis – it is very important to perform a general urine test during and after the disease to see if there is any hematuria – this parameter indicates kidney involvement;
7. sepsis.

Scarlet fever – treatment

Treatment of scarlet fever is pharmacological. Penicillin is used for a minimum of 10 days, as prescribed by the doctor. If you are allergic to penicillin, you can use macrolide antibiotics, e.g. azithromycin, clarithromycin, erythromycin. After a few days of taking the drug, the symptoms of scarlet fever may subside, but this does not mean that the antibiotic treatment can be stopped.

Persons with a history of scarlet fever develop permanent immunity to the disease. Nevertheless, about 1-4% of those who have had it are sometimes diagnosed with repeated illnesses. This is explained by the presence of various types of erythrogenic toxins.

Scarlet fever – home treatment

Treatment of scarlet fever with home remedies should only be an addition and not a substitute for taking antibiotics, especially bearing in mind the serious complications. First of all, it should be ensured that the patient receives the right amount of fluids and food in liquid or semi-liquid form. This is extremely important because a huge sore throat makes it practically impossible to eat solid foods.

In order to reduce the swelling of the throat, you can use a gargle with salt – one teaspoon of salt is poured into a glass of water. It is also very important to ventilate the apartment and change the bedding so that the amount of bacteria in the room where the patient is staying is minimized. In case of high fever, the patient may be given ibuprofen or paracetamol.

The person who is the carrier may not even know it. To check this, a throat swab should be taken, because streptococcus is located there. When scarlet fever has come back, penicillin will usually be re-prescribed.

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