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Scarlet fever (Scarlatina)
Scarlet fever is one caused acute infectious disease, hers for names of the typically scarlet red color of the pharynx and the tongue by bacteria (ß hemolyzing streptococci of the group of A) the fallen ill owes. Your most prominent disease symptoms are the typical sore throat, the strawberry tongue and the characteristic exanthema. Streptococcus infections are part of the most frequent bacterial illnesses with children. The causative agent is transferred by droplet infection and objects polluted. The gone illness leaves only an immunity against a specific Streptococcus type of the group of A. there are many different types there, the illness can appear repeatedly, too. Some children go through real "scarlet fever careers". Thanks to the therapy with antibiotics (penicillin), nowadays this illness is controllable well.
Children most frequently fall ill between 3 and 10 years. The illness appears in large numbers into party-line equipments, like nursery schools and schools. However, an illness in the adulthood isn't a rareness either. The seasonal illness peak lies Octobers until March within the months. About 20 -30 % of the population are infected with the shoot in the winter months without showing the specific disease symptoms. You are carriers, however, and contribute to the spreading. The illness must be notified of to the public health department in some federal states.
Streptococci of the group of A are bacteria which are spheroid and ordered into chains or into two groups which are held responsible for a variety of infectious diseases with children. Scarlet fever, infections of the upper air routes, the skin and soft parts, add occasionally meningitis and arthritis to it. The kontagionsindex is 10 to 30 per cent, this means 10 to 30 per cent of the contact persons at first contact with the shoot of infected fall ill. Streptococci of the group of A which cause scarlet fever form special toxic metabolic products (toxins) which cause the skin changes at the blood vessels, for example. The typical scarlet fever exanthema arises. The causative agent usually penetrates over the nose pharynx room one, rare about skin wounds (skin scarlet fever).
2 -4 is the incubation period, that is the period of time between the infection and the appearance of the first symptoms maximally 8 days.
Fell ill 48 hours after intake are no longer infectious with antibiotics therapy; smear positive, symptomless persons are no longer infectiously taking 24 hours after antibiotics. There otherwise is risk of infection up to the fading away of the symptoms. This can last for three to six weeks.
The course appears as follows:
The illness suddenly starts with sore throats, drink troubles, chill, head and rheumatic pains and exhaustion. Frequently the patients also complain of stomach ache and have to be sick. The fever can get very high 40 º C. The tongue is frequently covered whitish furredly to the beginning of the illness. The lymph nodes at the lower jaw are extended strongly.
Another symptom can be in the foreground at every scarlet fever illness, all symptoms don't have to appear either. The typical skin and mucosa changes appear only as of 2nd day or as of the 4th illness day. The pharynx changes color scarlet red, the mouth mucosa and the tonsils are colored stainedly, the child has strong drink troubles and often refuses even the nutrition. The white coating of the tongue goes back. Because of the gustatory papillas swollen up and lit the tongue looks raspberry like (strawberry tongue).
On the 2nd or 3rd days after the fever beginning the fine stained, velvety, red and eminent scarlet fever eruption blossoms out now, too. It feels like sandpaper. It starts out from the inguinal region and the shoulders and can cover the complete body. Merely the mouth area is from saved ("milksop"). Sometimes this eruption itches, however, it can also completely be missing. One till the skin peels itself after the disease beginning at the palms and the soles of the foot into a great shred three weeks.
Always go at suspicion of scarlet fever to the physician immediately. Serious complications can there at a quarter the fallen ill, this one should helping antibiotics therapy are started with as early as possible appear. The disease is course abbreviated considerably, the infection ability of your child stopped very rapidly in hers.
Your attending doctor will proceed as follows:
- If the illness has already further progressed, then your physician can diagnose the scarlet fever with the characteristic eruption and the typical clinical picture. The exact detection of the causative agent is made by a smear from the pharynx. With a dipstick test one knows within less minutes whether the streptococci are the etiology. In addition, the possibility passes the bacteria cultivating on a special blood agar. Bright halos around the bacterium colonies confirm the suspicion.
- Your physician will prescribe a highly dosed penicillin for you for your child whom it must take for ten days. This medicine gift leads to a quick defervescence of your child and protects from the complications of a scarlet fever illness. As an alternative to penicillin (for example at an allergy) your physician also can prescribe the antibiotic erythromycin or a cephalosporin for you.
- Your physician also can order you an antipyretic medicine at fever.
- Your physician will have the urine of your child examined for blood two weeks after the disease beginning. It has to be read whether there is a good chance for the complication of a kidney corpuscle inflammation (glomerulonephritis) from it.
- An ECG is made with your child six weeks after the disease beginning to exclude complications at the heart (myocarditis). The urine test is repeated.
The following measures should seize you yourself:
- Take care that your child takes the antibiotic as instructed even if it already seems healthy again.
- Go to the check-ups.
- You can try to lower the fever with compresses around the leg or give you the ordered antipyretic agentses.
- If your child suffers from drink troubles, then do without a firm nutrition and give your child cool or warm drinks as well as broth.
- If your child falls ill with scarlet fever once more after short time, then you think that also somebody from the family or frequent contact persons which seem healthy can transfer the causative agent. You also should if necessary have a pharynx smear made to avoid ping-ponging infections.
- The causative agents can remain infectious on objects for some time. To protect your child, other members of the family and playfellows from a renewed infection, you should disinfect as of the 3rd medical treatment day. Exchange the toothbrush of your child. They spray the toys, light switch etc. with a disinfectants. You strip the beds and you give them into the cook laundry, you wash the clothes of your child. You bath your child. Put the cuddling animals into the sun or under the UV light. You cover upholstered furniture with a lacquering if your child lies on you and you wash these then.
- Please inform the school, the nursery school and friends about the scarlet fever illness of your child. Think that many facilities require a medical certificate before re-visit.
The complication quota lies with not or not sufficient medical treatment at 25 per cent. It can come to complications with serious consequences about three to four weeks after the illness:
- If a myocarditis develops, then the consequence can be a valvular defect.
- An inflammation associated to fever of the joints is also possible. The subsequent illness is described as a rheumatic fever.
- The kidney corpuscles also can ignite. The kidneys eliminate increased egg-white and blood is found in the urine.
- Accompanyingly a purulent otitis media which can lead to the deafness at not sufficient treatment of the basic illness also can appear besides the strongly purulent tonsillitis.
- The septic course of the scarlet fever is very rare but dangerous. It is a form of the scarlet fever shock which is malignant and going perhaps deadly heavy heart lesion and with a suddenly high fever, vomiting, diarrhea, skin mucosa bleedings, consciousness ring opacity.
Scarlet fever prophylactically cannot be vaccinated against. Also after gone infection a counter-infection is possible. Children should be isolated by other children scarlet fever sick person. A pharynx smear can give information about it, whether with members of the family still seeming healthy the infection has already taken place and possible you start with the antibiotics' therapy at once before outbreak of the illness.
These informations may be considered a substitute for a piece of medical advice in no case. The content of health-illness.com doesn't can and may be put into any case to make diagnoses or carry out self medical treatment independently.
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