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Scarlet fever rash images photos: Scarlet Fever Condition, Treatments, and Pictures for Parents – Overview

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Scarlet Fever Condition, Treatments, and Pictures for Parents – Overview

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Information for
ChildInfant

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Images of Scarlet Fever (Scarlatina)

Overview

Scarlet fever is an infection with a type of bacteria called Streptococcus, which not only causes a throat infection (“strep throat”), but also produces a poison (toxin) causing the distinctive rash of scarlet fever. Some people are more sensitive to the toxin than others, so not everyone in a family who is infected will have the rash, even if they have the throat infection. Sometimes the area of infection is the skin rather than the throat, a condition called impetigo.

Scarlet fever is contagious to people who come into close contact with an infected child.

Complications are rare but can include deeper tissue infections, rheumatic fever, and kidney disease.

Who’s at risk?

  • Scarlet fever is rare in children under the age of 2, because substances from the mother’s immune system (antibodies) protect the child up to that age.
  • The peak ages for infection are 4–8 years. By age 10, most children have developed their own immunity to the toxin.
  • Because infection is spread by fluids from the airways (respiratory secretions), infection rates are higher in crowded situations.

Signs and Symptoms

Scarlet fever is accompanied by a sandpaper-like rash of 1–2 mm red bumps, which merge together, starting on the neck, then moving to the trunk, and finally to the arms and legs (extremities). It is sometimes a bit itchy. If scarlet fever develops on body creases (armpits, elbow folds), red streaks may appear.

Fever, chills, body aches, nausea, vomiting, and loss of appetite may occur.

When the throat is the main area of infection, the tonsils may become enlarged, red, and tender. Other areas (lymph nodes) in the neck may become swollen. At first, the tongue has a white coating, giving a “white strawberry” tongue appearance, which then falls off (sheds) to reveal a bright red strawberry tongue. The rash does not affect the palms and soles at first, but later on, these areas may peel. The rash usually lasts for 4–5 days, and as it fades (subsides), skin on the neck and face start to peel, and eventually the hands and feet start to peel as well.

Self-Care Guidelines

It is difficult to avoid infection of others who are not immune in the household. However, you might try to:

  • Keep eating and clothing items used by an ill child away from other people, and wash them in hot soapy water.
  • The child’s caregivers should wash their hands frequently.
  • Keep the child comfortable with acetaminophen (Tylenol®) or ibuprofen for fever relief.
  • Have your child eat soft foods, drink plenty of liquids, and apply lotions such as calamine for itching, if needed.

When to Seek Medical Care

Call your child’s doctor if you suspect that the child may have scarlet fever.

Treatments Your Physician May Prescribe

The doctor will usually do a throat or skin culture or a rapid-strep test to confirm the diagnosis. If Streptococcus infection is confirmed, prescription antibiotics are will be prescribed, to be taken for about 10 days.

Trusted Links

Clinical Information and Differential Diagnosis of Scarlet Fever (Scarlatina)

References

Bolognia, Jean L., ed. Dermatology, pp.1119-1120. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed. pp.1871-1873. New York: McGraw-Hill, 2003.

Scarlet Fever Condition, Treatments, and Pictures for Parents – Overview

52301
33

Information for
ChildInfant

caption goes here. ..

Images of Scarlet Fever (Scarlatina)

Overview

Scarlet fever is an infection with a type of bacteria called Streptococcus, which not only causes a throat infection (“strep throat”), but also produces a poison (toxin) causing the distinctive rash of scarlet fever. Some people are more sensitive to the toxin than others, so not everyone in a family who is infected will have the rash, even if they have the throat infection. Sometimes the area of infection is the skin rather than the throat, a condition called impetigo.

Scarlet fever is contagious to people who come into close contact with an infected child.

Complications are rare but can include deeper tissue infections, rheumatic fever, and kidney disease.

Who’s at risk?

  • Scarlet fever is rare in children under the age of 2, because substances from the mother’s immune system (antibodies) protect the child up to that age.
  • The peak ages for infection are 4–8 years. By age 10, most children have developed their own immunity to the toxin.
  • Because infection is spread by fluids from the airways (respiratory secretions), infection rates are higher in crowded situations.

Signs and Symptoms

Scarlet fever is accompanied by a sandpaper-like rash of 1–2 mm red bumps, which merge together, starting on the neck, then moving to the trunk, and finally to the arms and legs (extremities). It is sometimes a bit itchy. If scarlet fever develops on body creases (armpits, elbow folds), red streaks may appear.

Fever, chills, body aches, nausea, vomiting, and loss of appetite may occur.

When the throat is the main area of infection, the tonsils may become enlarged, red, and tender. Other areas (lymph nodes) in the neck may become swollen. At first, the tongue has a white coating, giving a “white strawberry” tongue appearance, which then falls off (sheds) to reveal a bright red strawberry tongue. The rash does not affect the palms and soles at first, but later on, these areas may peel. The rash usually lasts for 4–5 days, and as it fades (subsides), skin on the neck and face start to peel, and eventually the hands and feet start to peel as well.

Self-Care Guidelines

It is difficult to avoid infection of others who are not immune in the household. However, you might try to:

  • Keep eating and clothing items used by an ill child away from other people, and wash them in hot soapy water.
  • The child’s caregivers should wash their hands frequently.
  • Keep the child comfortable with acetaminophen (Tylenol®) or ibuprofen for fever relief.
  • Have your child eat soft foods, drink plenty of liquids, and apply lotions such as calamine for itching, if needed.

When to Seek Medical Care

Call your child’s doctor if you suspect that the child may have scarlet fever.

Treatments Your Physician May Prescribe

The doctor will usually do a throat or skin culture or a rapid-strep test to confirm the diagnosis. If Streptococcus infection is confirmed, prescription antibiotics are will be prescribed, to be taken for about 10 days.

Trusted Links

Clinical Information and Differential Diagnosis of Scarlet Fever (Scarlatina)

References

Bolognia, Jean L., ed. Dermatology, pp.1119-1120. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed. pp.1871-1873. New York: McGraw-Hill, 2003.

Scarlet Fever: All You Need to Know

Bacteria Cause Scarlet Fever

Bacteria called group A Streptococcus or group A strep cause scarlet fever. The bacteria sometimes make a poison (toxin), which causes a rash — the “scarlet” of scarlet fever.

How You Get Scarlet Fever

Group A strep live in the nose and throat and can easily spread to other people. It is important to know that all infected people do not have symptoms or seem sick. People who are infected spread the bacteria by coughing or sneezing, which creates small respiratory droplets that contain the bacteria.

People can get sick if they:

  • Breathe in those droplets
  • Touch something with droplets on it and then touch their mouth or nose
  • Drink from the same glass or eat from the same plate as a sick person
  • Touch sores on the skin caused by group A strep (impetigo)

Rarely, people can spread group A strep through food that is not handled properly (visit CDC’s food safety page). Experts do not believe pets or household items, like toys, spread these bacteria.

  • Very red, sore throat
  • Fever (101 °F or higher)
  • Whitish coating on the tongue early in the illness
  • “Strawberry” (red and bumpy) tongue
  • Red skin rash that has a sandpaper feel
  • Bright red skin in the creases of the underarm, elbow, and groin (the area where your stomach meets your thighs)
  • Swollen glands in the neck

Other general symptoms:

  • Headache or body aches
  • Nausea, vomiting, or abdominal pain

Scarlet Fever: What to Expect

In general, scarlet fever is a mild infection. It usually takes two to five days for someone exposed to group A strep to become sick. Illness usually begins with a fever and sore throat. There may also be chills, vomiting, or abdominal pain. The tongue may have a whitish coating and appear swollen. It may also have a “strawberry”-like (red and bumpy) appearance. The throat and tonsils may be very red and sore, and swallowing may be painful.

One or two days after the illness begins, a red rash usually appears. However, the rash can appear before illness or up to 7 days later. The rash may first appear on the neck, underarm, and groin (the area where your stomach meets your thighs). Over time, the rash spreads over the body. The rash usually begins as small, flat blotches that slowly become fine bumps that feel like sandpaper.

Although the cheeks might look flushed (rosy), there may be a pale area around the mouth. Underarm, elbow, and groin skin creases may become brighter red than the rest of the rash. The rash from scarlet fever fades in about 7 days. As the rash fades, the skin may peel around the fingertips, toes, and groin area. This peeling can last up to several weeks.

Children and Certain Adults Are at Increased Risk

Anyone can get scarlet fever, but there are some factors that can increase the risk of getting this infection.

Scarlet fever, like strep throat, is more common in children than adults. It is most common in children 5 through 15 years old. It is rare in children younger than 3 years old. Adults who are at increased risk for scarlet fever include:

  • Parents of school-aged children
  • Adults who are often in contact with children

Close contact with another person with scarlet fever is the most common risk factor for illness. For example, if someone has scarlet fever, it often spreads to other people in their household.

Infectious illnesses tend to spread wherever large groups of people gather together. Crowded conditions can increase the risk of getting a group A strep infection. These settings include:

  • Schools
  • Daycare centers
  • Military training facilities

Doctors Can Test for and Treat Scarlet Fever

Many viruses and bacteria can cause an illness that includes a red rash and sore throat. Only a rapid strep test or a throat culture can determine if group A strep are the cause.

A rapid strep test involves swabbing the throat and testing the swab. The test quickly shows if group A strep are causing the illness. If the test is positive, doctors can prescribe antibiotics. If the test is negative, but a doctor still suspects scarlet fever, then the doctor can take a throat culture swab. A throat culture takes time to see if group A strep bacteria grow from the swab. While it takes more time, a throat culture sometimes finds infections that the rapid strep test misses. Culture is important to use in children and teens since they can get rheumatic fever from an untreated scarlet fever infection. For adults, it is usually not necessary to do a throat culture following a negative rapid strep test. Adults are generally not at risk of getting rheumatic fever following scarlet fever.

Antibiotics Get You Well Fast

Doctors treat scarlet fever with antibiotics. Either penicillin or amoxicillin are recommended as a first choice for people who are not allergic to penicillin. Doctors can use other antibiotics to treat scarlet fever in people who are allergic to penicillin.

Benefits of antibiotics include:

  • Decreasing how long someone is sick
  • Decreasing symptoms (feeling better)
  • Preventing the bacteria from spreading to others
  • Preventing serious complications like rheumatic fever

Long-term Health Problems Are Not Common but Can Happen

Complications are rare but can occur after having scarlet fever. This can happen if the bacteria spread to other parts of the body. Complications can include:

Treatment with antibiotics can prevent most of these health problems.

Protect Yourself and Others

People can get scarlet fever more than once. Having scarlet fever does not protect someone from getting it again in the future. While there is no vaccine to prevent scarlet fever, there are things people can do to protect themselves and others.

Good Hygiene Helps Prevent Group A Strep Infections

The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating. To practice good hygiene, you should:

  • Cover your mouth and nose with a tissue when you cough or sneeze
  • Put your used tissue in the waste basket
  • Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue
  • Wash your hands often with soap and water for at least 20 seconds
  • Use an alcohol-based hand rub if soap and water are not available

You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.

Antibiotics Help Prevent Spreading the Infection to Others

People with scarlet fever should stay home from work, school, or daycare until they:

  • No longer have a fever
    AND
  • Have taken antibiotics for at least 12 hours

Take the prescription exactly as the doctor says to. Don’t stop taking the medicine, even if you or your child feel better, unless the doctor says to stop.

 

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Scarlet Fever: Background, Pathophysiology, Etiology

Author

Bahman Sotoodian, MD Resident Physician, Department of Dermatology, University of Alberta Faculty of Medicine and Dentistry, Canada

Disclosure: Nothing to disclose.

Coauthor(s)

Jaggi Rao, MD, FRCPC Clinical Professor of Medicine, Division of Dermatology and Cutaneous Sciences, Director of Dermatology Residency Program, University of Alberta Faculty of Medicine and Dentistry, Canada

Jaggi Rao, MD, FRCPC is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, Canadian Dermatology Association, Canadian Medical Association, Canadian Medical Protective Association, Pacific Dermatologic Association, Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Additional Contributors

Edward J Zabawski, Jr, DO Medical and Surgical Dermatology

Edward J Zabawski, Jr, DO is a member of the following medical societies: American Osteopathic Association, New England Dermatological Society

Disclosure: Nothing to disclose.

Acknowledgements

Jerry Balentine, DO is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American College of Physician Executives, American Osteopathic Association, and New York Academy of Medicine

Disclosure: Nothing to disclose.

Peter Bloomfield, MD, MPH Clinical Instructor, Department of Emergency Medicine, Olive View-UCLA Medical Center

Disclosure: Nothing to disclose.

Pamela L Dyne, MD Professor of Clinical Medicine/Emergency Medicine, University of California, Los Angeles, David Geffen School of Medicine; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center

Disclosure: Nothing to disclose.

Craig A Elmets, MD Professor and Chair, Department of Dermatology, Director, UAB Skin Diseases Research Center, University of Alabama at Birmingham School of Medicine

Craig A Elmets, MD is a member of the following medical societies: American Academy of Dermatology, American Association of Immunologists, American College of Physicians, American Federation for Medical Research, and Society for Investigative Dermatology

Disclosure: Palomar Medical Technologies Stock None; Astellas Consulting fee Review panel membership; Massachusetts Medical Society Salary Employment; Abbott Laboratories Grant/research funds Independent contractor; UpToDate Salary Employment; Biogen Grant/research funds Independent contractor; Clinuvel Independent contractor; Covan Basilea Pharmaceutical Grant/research funds Independent contractor; ISDIN None Consulting; TenX BIopharma Grant/research funds Independent contractor

Daniel P Lombardi, DO is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, and American Osteopathic Association

Disclosure: Nothing to disclose.

Robert E O’Connor, MD, MPH Professor and Chair, Department of Emergency Medicine, University of Virginia Health System

Robert E O’Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physician Executives, American Heart Association, American Medical Association, Medical Society of Delaware, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society

Joseph A Salomone III, MD Associate Professor and Attending Staff, Truman Medical Centers, University of Missouri-Kansas City School of Medicine; EMS Medical Director, Kansas City, Missouri

Joseph A Salomone III, MD is a member of the following medical societies: American Academy of Emergency Medicine, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Disclosure: Nothing to disclose.

Eric L Weiss, MD, DTM&H Medical Director, Office of Service Continuity and Disaster Planning, Fellowship Director, Stanford University Medical Center Disaster Medicine Fellowship, Chairman, SUMC and LPCH Bioterrorism and Emergency Preparedness Task Force, Clinical Associate Progressor, Department of Surgery (Emergency Medicine), Stanford University Medical Center

Eric L Weiss, MD, DTM&H is a member of the following medical societies: American College of Emergency Physicians, American College of Occupational and Environmental Medicine, American Medical Association, American Society of Tropical Medicine and Hygiene, Physicians for Social Responsibility, Southeastern Surgical Congress, Southern Association for Oncology, Southern Clinical Neurological Society, and Wilderness Medical Society

Garry Wilkes, MBBS, FACEM Director of Emergency Medicine, Calvary Hospital, Canberra, ACT; Adjunct Associate Professor, Edith Cowan University, Western Australia

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Grace M Young, MD Associate Professor, Department of Pediatrics, University of Maryland Medical Center

Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Emergency Physicians

Rheumatic Heart Disease | Johns Hopkins Medicine

What is rheumatic heart disease?

Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever. An immune response causes an inflammatory condition in the body which can result in on-going valve damage.

What causes rheumatic heart disease?

Rheumatic heart disease is caused by rheumatic fever, an inflammatory disease that can affect many connective tissues, especially in the heart, joints, skin, or brain. The heart valves can be inflamed and become scarred over time. This can result in narrowing or leaking of the heart valve making it harder for the heart to function normally. This may take years to develop and can result in heart failure.

Rheumatic fever can occur at any age, but usually occurs in children ages 5 to 15 years old. It’s rare in developed countries like the United States.

Who is at risk for rheumatic heart disease?

Untreated or under-treated strep infections can increase the risk for rheumatic heart disease. Children who get repeated strep throat infections are at the most risk for rheumatic fever and rheumatic heart disease.

What are the symptoms of rheumatic heart disease?

A recent history of strep infection or rheumatic fever is key to the diagnosis of rheumatic heart disease. Symptoms of rheumatic fever vary and typically begin 1 to 6 weeks after a bout of strep throat. In some cases, the infection may have been too mild to have been recognized, or it may be gone by the time the person sees a doctor.

These are the most common symptoms of rheumatic fever:

  • Fever

  • Swollen, tender, red and extremely painful joints — particularly the knees and ankles

  • Nodules (lumps under the skin)

  • Red, raised, lattice-like rash, usually on the chest, back, and abdomen

  • Shortness of breath and chest discomfort

  • Uncontrolled movements of arms, legs, or facial muscles

  • Weakness

Symptoms of rheumatic heart disease depend on the degree of valve damage and may include:

How is rheumatic heart disease diagnosed?

People with rheumatic heart disease will have or recently had a strep infection. A throat culture or blood test may be used to check for strep.

They may have a murmur or rub that may be heard during a routine physical exam. The murmur is caused by the blood leaking around the damages valve. The rub is caused when the inflamed heart tissues move or rub against each other.

Along with a complete medical history and physical exam, tests used to diagnose rheumatic heart disease may include:

  • Echocardiogram (echo). This test uses sound waves to check the heart’s chambers and valves. The echo sound waves create a picture on a screen as an ultrasound transducer is passed over the skin overlying the heart. Echo can show damage to the valve flaps, backflow of blood through a leaky valve, fluid around the heart, and heart enlargement. It’s the most useful test for diagnosing heart valve problems.

  • Electrocardiogram (ECG). This test records the strength and timing of the electrical activity of the heart. It shows abnormal rhythms (arrhythmias or dysrhythmias) and can sometimes detect heart muscle damage. Small sensors are taped to your skin to pick up the electrical activity.

  • Chest X-ray. An X-ray may be done to check your lungs and see if your heart is enlarged.

  • Cardiac MRI. This is an imaging test that takes detailed pictures of the heart. It may be used to get a more precise look at the heart valves and heart muscle.

  • Blood tests. Certain blood tests may be used to look for infection and inflammation.

How is rheumatic heart disease treated?

Treatment depends in large part on how much damage has been done to the heart valves. In severe cases, treatment may include surgery to replace or repair a badly damaged valve.

The best treatment is to prevent rheumatic fever. Antibiotics can usually treat strep infections and keep rheumatic fever from developing. Anti-inflammatory drugs may be used to reduce inflammation and lower the risk of heart damage. Other medicines may be needed to manage heart failure.

People who have had rheumatic fever are often given daily or monthly antibiotic treatments, possibly for life, to prevent recurrent infections and lower the risk of further heart damage. To reduce inflammation, aspirin, steroids, or non-steroidal medicines may be given.

What are the complications of rheumatic heart disease?

Some complications of rheumatic heart disease include:

  • Heart failure. This can occur from either a severely narrowed or leaking heart valve.

  • Bacterial endocarditis. This is an infection of the inner lining of the heart, and may occur when rheumatic fever has damaged the heart valves.

  • Complications of pregnancy and delivery due to heart damage. Women with rheumatic heart disease should discuss their condition with their healthcare provider before getting pregnant.

  • Ruptured heart valve. This is a medical emergency that must be treated with surgery to replace or repair the heart valve.

Can rheumatic heart disease be prevented?

Rheumatic heart disease can be prevented by preventing strep infections or treating them with antibiotics when they do occur. It’s important to take antibiotics as prescribed and to complete them as instructed, even if you feel better after a few days.

Living with rheumatic heart disease

You will need to have ongoing follow-up with your healthcare provider to check the condition of your heart. Depending on the amount of heart damage, you may have some activity restrictions. Your healthcare provider may recommend that you take antibiotics for an extended period to prevent another infection of rheumatic fever.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, call your healthcare provider.

Key points

  • Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever.

  • Rheumatic fever is an inflammatory disease that can affect many connective tissues, especially in the heart.

  • Untreated or under-treated strep infections put a person at increased risk. Children who get repeated strep throat infections are at the most risk for rheumatic fever and rheumatic heart disease.

  • A recent history of strep infection or rheumatic fever is key to the diagnosis of rheumatic heart disease. Symptoms of rheumatic fever vary and typically begin 1 to 6 weeks after a bout of strep throat.

  • People with rheumatic heart disease may have a murmur or rub that may be heard during a routine physical exam.

  • Treatment depends on how much damage has been done to the heart valves. It may even include surgery to replace or repair a badly damaged valve.

  • Since rheumatic fever is the cause of rheumatic heart disease, the best treatment is to prevent rheumatic fever by using antibiotics to treat strep infections.

Strep Throat (Bacterial): Symptoms, Diagnosis and Treatment

There are two different germs that cause sore throats: viruses and bacteria. Most sore throats are caused by viruses. The one that comes on suddenly is caused by bacteria (germs) called “strep,” short for streptococci (strep toe KAW ki). If untreated, it can lead to complications and be spread to others.

Strep throat is contagious (can be spread to others). The strep bacteria hang out in the nose and throat. When the infected person coughs, sneezes or talks, the germs go into the air. The germs are then breathed in or caught by touching something that the germs are on (contaminated). Strep throat is most common in school age children but anyone can be infected with strep.

Antibiotic medicine must be given as soon as possible to prevent the strep germs from spreading in the body. The bacteria can cause damage to the kidneys or to the heart (Rheumatic fever). Rheumatic fever can cause painful and swollen joints, a specific type of rash, or harm the heart.

There are some people with strep who should not be given antibiotics. Strep bacteria can sometimes live on children’s throats without causing illness. As many as 1 in 5 children are “strep carriers.” This means that they have no symptoms, they are not contagious and their throat strep test stays positive even after taking antibiotics. If your child gets a sore throat and you know that he or she is a strep carrier, the doctor will treat it like a virus.

Symptoms

A child with strep throat, may have some or all of these symptoms:

  • Sore throat, especially when swallowing
  • Bright red, swollen tonsils, sometimes with white patches or streaks of pus
  • “Strawberry” look to the tongue or tiny red spots on the back roof of the mouth
  • Fever
  • Swollen, tender glands in the neck
  • Headache, irritability or fussiness
  • Sleeping more than usual
  • Poor appetite, nausea or vomiting, especially in younger children
  • Pain in the abdomen (tummy)
  • A red rash on the body that “feels like sandpaper. ” It may appear 12 to 48 hours after the first symptoms. This is known as scarlet fever or scarlatina.

When a child has a cough, hoarseness, red eyes and runny nose, it may be due to a virus, the flu or a different illness rather than strep.

Diagnosis

The health provider will examine your child, check for signs and symptoms and do a strep test.

A sample will be taken from the throat and tested. Two cotton-tipped swabs will be swiped over the back of the throat and tonsils. This should not hurt but may cause your child to gag. The lab will do one or more tests on the sample.

  • Rapid strep test screen (rapid antigen test): The test usually takes up to half an hour. You will be asked to wait until the test results are read. A “positive” test means your child has strep throat caused by bacteria. If the rapid strep test screen is negative and the doctor still suspects strep, a follow-up test will be done.
  • Second test to confirm the rapid strep test: Your child will not need another throat swab done for a follow-up test. The same sample will be tested in a different way to confirm the result of the rapid strep test. If the second test is positive, you will be notified the next day so that your child can be treated with antibiotics. A negative test means the sore throat is likely caused by a virus and does not need antibiotics.

Strep carriers do not need to have repeated strep tests done. Doing throat swabs on children who are strep carriers may cause them to take antibiotics that they do not need.

Treatment with Antibiotics

A positive strep test must be treated with antibiotic medicine within a few days to prevent the germs from causing problems. Antibiotics are not given to strep carriers or to treat viruses because and they will not be effective. Antibiotics can have side effects such as diarrhea and rash.

Antibiotic medicine is usually taken by mouth but may be given by injection. Your child should start feeling better within a day or two.

It is very important to take all the medicine for ten days, as ordered, even after starting to feel better (Picture 1). When antibiotics are not used correctly (such as taking too much, missing doses or not finishing a prescription), some bacteria can develop resistance. Resistance can make infections very hard to treat. Sometimes they cannot be treated at all.

If your child is allergic to penicillin, be sure to tell the doctor. Another medicine will be prescribed.

Comfort and Care

  • If your child has a fever or throat pain, give acetaminophen (such as Tylenol®) or ibuprofen (Advil®, Motrin®) as directed. Read the label to know the right dose for your child. Do not give aspirin or products that contain aspirin.
  • Give your child lots of liquids, such as water, Pedialyte®, apple juice or popsicles. Give small amounts of liquid often.
  • Give soft foods that are easy to swallow, such as applesauce, mashed potatoes, hot cereal or eggs. Your child may not want to eat much if it hurts to swallow.
  • To soothe a sore throat offer:
    • For children over age 1, warm fluids such as chicken broth or apple juice
    • For children over age 4, throat or cough lozenges or throat sprays. Read the label to know the right dose for your child. Do not use throat sprays that contain benzocaine, as this could cause a drug reaction.
    • For children over age 6 who are able to gargle without swallowing, a mixture of ½ teaspoon of table salt in 8 ounces of warm water. Swish and gargle the mixture 2 to 3 times a day for the next few days. Do not let your child swallow the salt water; have him spit it out.

How to Protect Others

  • Everyone should wash hands often with soap or hand sanitizer. Good handwashing prevents the spread of infection.
  • Cover the mouth when coughing or sneezing. Give your child a paper bag and have him put his used tissues in the bag. Moisture from the child’s nose and mouth is contagious.
  • Do not share drinking cups or eating utensils.
  • Throw away your child’s toothbrush and buy a new one as soon as the illness is over. (Strep throat germs may still be on your child’s toothbrush.)
  • Keep your child away from others for 24 hours after the medicine is started and until he has no fever.
  • Tell the school nurse and your child’s teacher that your child has strep throat. It is important for school personnel to know so that other parents can be told to watch for symptoms in their children.
  • If anyone in the family gets a sore throat, he should be checked by a doctor to see if medical treatment is needed.

When to Call the Doctor

Your child:

  • Has a fever more than 102˚F that lasts more than 2 days after taking an antibiotic
  • Has a sore throat that lasts more than 3 days after taking an antibiotic
  • Develops a rash or diarrhea after taking antibiotics
  • Starts drooling, cannot talk or voice becomes muffled

When to Return to School or Daycare

Your child should stay home from school or childcare until he has taken antibiotic medicine for 24 hours and has no fever.

Strep Throat – Bacterial (PDF)

HH-I-122 11/89, Revised 10/17 Copyright 1989, Nationwide Children’s Hospital

Dermatology

Approach to Pediatric Dermatology

 

Author: Natalie Yapo MD, FAAP, Pediatric Emergency Medicine Fellow, University of Chicago

Author: S. Margaret Paik, MD, Associate Professor of Pediatrics, The University of Chicago, Comer Children’s Hospital, Chicago, IL

Editor: Matthew Tews, Medical College of Wisconsin

Last Update: 2015


Objectives     

  1. Describe the general approach to describing rashes
  2. Identify distinguishing features of common pediatric infectious rashes
  3. Distinguish life-threatening rashes in children

Initial Assessment and Primary Survey

Rash is a common chief complaint for children in the emergency department. The general approach to the evaluation of rashes is to first identify whether the child is sick versus not sick. By going through the ABC’s as well as understanding age appropriate vital signs, the clinician should be able to identify children that are ill and may require a work up or a timely intervention.

In the initial evaluation, the child’s airway should be assessed. Urticaria may be associated with airway compromise such as stridor in the case of anaphylaxis. The child’s breathing should be assessed including the oxygen saturation and respiratory effort. When assessing the child’s circulation, the clinician needs to be aware whether the heart rate and blood pressure are age appropriate. The quality of central pulses (brachial, femoral, carotid) is also paramount in the circulation assessment.

When assessing the rash, describing the appearance, distribution and associated symptoms are paramount in figuring out the etiology of the rash. Below is a table that outlines the descriptions of rashes.


Rash Description

Figures from Wikimedia.org


Differential Diagnosis

Infectious Rashes in Ill Appearing Child

Meningococcemia

Meningococcemia, which is due to Neisseria meningitides, will often present in an ill appearing patient. Children less than 12 months are at the highest risk of meningococcemia.   Apart from fever, irritability and meningitis signs and symptoms, 2/3 of those affected will have a cutaneous manifestation. Early on the rash may appear morbilliform or urticarial macules and papules that often progress to petechial, pustules and vesicles. Late cutaneous features will include purpuric (non-blanching) lesions with jagged edges. Confirmatory tests include culture of the blood and CSF.

Purpuric rash 
Pictures from Wikimedia.org

Staphylococcal Scalded Skin Syndrome (SSSS)

SSSS is a toxin mediated rash produced by Staphylococcus aureus.  Children less than 5 years are usually affected and present with a generalized tender erythroderma and flaccid bullae. SSSS is typically associated with a positive Nikolsky sign, rubbing of the skin that causes skin desquamation or creates abullae within minutes.  The mucous membranes are often spared. Diagnosis is largely a clinical diagnosis as the bullae are sterile.

A.

B.

SSSS
Picture A: note the flaccid bullae
Picture B: erythroderma with bullae
Pictures courtesy of Dr. S Margaret Paik

Herpes Simplex Infection

Herpes Simplex Viral (HSV) Infection can cause localized or widespread infection. The classic rash associated with HSV is a painful vesicular (1-2 mm) and/ or ulcerative rash on an erythematous base. HSV-1 infection typically causes a localized infection of the mouth (herpetic gingivostomatitis), lips and/or eyes.  HSV-2 infection is commonly associated with genital infections and typically transmitted through sexual contact.

A child with herpetic gingivostomatitis usually has a fever accompanied by a vesicular and/or ulcerative rash of the buccal mucosa, tongue, gingivae, and perioral skin.  This differs from herpangina, which commonly appears on the soft palate, tonsillar pillars, uvula and posterior pharynx (see below for description).

If an HSV rash is located on the digits, it is referred to as a herpetic whitlow. In a child with atopic dermatitis with an overlying herpetic rash is referred to as eczema herpeticum .

Usually treatment options with acyclovir, valacyclovir or famciclovir are most efficacious when given within 48 hours of symptoms. Those with lesions proximal to the eyes should be urgently evaluated by ophthalmology . Those that appear ill, infants < 6 weeks old, signs of central disease (seizures, lethargy, altered mental status), immunocompromised, or widespread eczema herpeticum should be admitted for parenteral therapy.

A.

B.

Herpetic Gingivostomatitis
Picture A: note ulcers below two bottom teeth
Picture B: herpetic lesions on gingiva
Pictures from Wikimedia.org

 

 

 

 

Herpetic Conjunctivitis 
Note the vesicular lesions accompanied with conjunctival injection and
eyelid swelling (blepharitis).
Picture courtesy of Dr. S Margaret Paik

 

 

 

 

 

 

Eczema Herpeticum
Note the eczema of arms and face with small ulcerative rash on an erythematous base around mouth
Picture courtesy of Dr. S Margaret Paik


Non-Infectious Rashes in Ill Appearing Child

Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)

SJS and TEN are characterized by cutaneous and mucous membrane epidermal disruption. 

In Stevens Johnson Syndrome (SJS), the rash is preceded by  prodromal symptoms of fever, malaise, headache, sore throat for 1-14 days. The rash is described as target lesions which are erythematous concentric lesions with central duskiness that may turn into a blister and/or erosion. The rash commonly involves the palms and soles and <10% of the body surface area is involved in SJS.  The hallmark of SJS is the association of a characteristic rash with the involvement of >2 mucosal sites, i. e. oral, conjunctiva, urethral, esophageal.  Universally, hemorrhagic crusting of the lips and oral cavity are seen with SJS. The etiology of SJS may be drug related  (ie: anti-epileptics, NSAIDS, sulfonamides, acetaminophen) or infectious (ie: HSV, mycoplasma, EBV) or.  Treatment is largely supportive care and discontinuing offending drug agents.

SJS
Picture A: Target lesion, note central duskiness
Picture B and C: Examples of mucosal involment of  oral cavity 
and conjunctiva respectively 
Pictures from Wikimedia.org

Toxic Epidermal Necrolysis (TEN) is a severe form of SJS in that greater than 30% of the body surface area is involved. TEN is associated with multiorgan failure, >2 mucosal site involvement and rash characterized by widespread bullae eruption leading to epidermal sloughing. Usually those with TEN will need to be transferred to a burn unit and received intensive care monitoring.

TEN
Note widespread bullae 
Pictures from Wikimedia. org

Urticaria associated with anaphylaxis

Urticaria is described as pink to erythematous wheals that are pruritic and vary in shape and size. By definition, an urticarial lesion should change in its morphology or resolve within 24 hours. Acute urticaria (<6 weeks of duration) is typically benign. However when a child is experiencing anaphylaxis, an urticarial rash is the typical cutaneous manifestation.  Anaphylaxis is a potentially fatal disease that occurs after exposure to an allergen and causes a massive release of histamines, prostaglandins, and leukotrienes. Diagnosis is largely clinical and consists of the development of signs/symptoms within minutes to hours after an exposure. Such signs/symptoms include hypotension, cutaneous manifestations (urticaria, angioedema), respiratory signs (stridor, wheezing), and persistent gastrointestinal symptoms (emesis, abdominal pain). Treatment of urticaria can include oral anti-histamines such as diphenhydramine or .  Newer generation h2 blockers such as loratadine and cetirizine may also be used as they have a less sedating profile. Systemic corticosteroids are usually reserved for severe disease and can be associated with a rebound flare upon cessation. The first-line treatment of anaphylaxis includes IM epinephrine. In addition, one should also consider systemic corticosteroids, diphenhydramine and h3 blockers such as or famotidine as second-line therapy for anaphylaxis.

Urticaria
Pictures from Wikimedia.org

Henoch-Schonlein Pupura (HSP)

HSP is a type of vasculitis of unknown etiology.  A child with HSP will typically have a non-thrombocytopenic palpable purpuric (non-blanching) rash in the dependent areas such as lowers extremities and buttocks.  However, the rash can also present in the upper extremities, thorax, and face.  The rash may also be urticarial wheals or a maculopapular rash. Other associated symptoms may be arthritis, arthralgia, edema, and abdominal pain. Intussusception can occur in 2-3% of patients and 20-50% of patients will have renal involvement ranging from microscopic hematuria to glomerulonephritis.   Evaluation of a child with HSP should include a urinalysis (UA) to assess for hematuria and proteinuria as well as checking a blood pressure to assess for hypertension. There is no specific treatment for the rash as it will self-resolve. NSAIDS can be given for arthralgia and arthritis.  Corticosteroids have been shown to ameliorate GI symptoms.

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B.

HSP 
Note purpura of buttock extending to thighs 
Pictures courtesy of Dr. S Margaret Paik


Infectious Rashes in Well Appearing Child

Scarlet Fever

Scarlet fever is the association of a toxin-mediated exanthem from group A beta hemolytic streptococcus and pharyngitis or a skin wound. The rash is known as scarlatina. Children 4-8 years of age are most affected and typically present with fever, pharyngitis, headache and a rash. The hallmark of scarlatina is a widespread erythematous pinpoint papules described as a sandpaper rash, the presence of petechiae in the axillary folds or antecubital fossa known as Pastia lines, prominent papillae of the tongue (strawberry tongue), red cheeks with circumoral pallor. Confirmatory tests include rapid strep throat culture and/or throat strep culture.

Scarlett Fever
A. Example of strawberry tongue 
B. Note red cheeks with perioral pallor 
C. Erythematous papules “Sandpapery Rash”
D. Pastia lines in antecubital fossa
Pictures A,B, C from Wikimedia.org
Picture D courtesy of Dr. Natalie Yapo

Tinea Corporus/ Tinea Capitus

Tinea capitus is an infection of the scalp caused by a dermatophyte.  The infection may have different characteristics depending on the type of dermatophyte infection. The infection may result in circular patches of alopecia and scaling. Black dots may be seen due to remaining hair remnants in the follicle.  The infection may resemble seborrheic dermatitis (dandruff) in that there are patchy white to gray scaling with minimal alopecia. An inflamed tinea capitus lesion referred to as a kerion will present with a tender, erythematous boggy mass. Tinea capitus is often associated with suboccipital or posterior cervical lymphadenopathy. Typically this infection is clinically diagnosed but the gold standard for diagnosis is a fungal culture of a scale or hair fragment. Treatment of tinea capitus is an oral antifungal such as griseofulvin for 6-8 weeks.  Terbinafine is often used for refractory cases. An antifungal shampoo should also be used twice a week to decrease spread of infection.  Oral steroids should be considered as an adjunctive therapy for the treatment of a kerion.

A.

B.

Picture A: Tinea capitus-note the patch of alopecia with black dots
Picture B: Kerion- note the boggy erythematous appearance with associated alopecia
Pictures from Wikimedia.org

Tinea corporis is a cutaneous infection caused by a dermatophyte and causes annular lesions with a raised erythematous border and central clearing with associated scaling. A topical antifungal imidazole cream or ointment such as clotrimazole or topical allylamine such as terbinafine can used for treatment. Oral agents are reserved for extensive disease.

Tinea corporis-note the erythematous raised border with central clearing. 
Pictures from Wikimedia.org

Viral Exanthum

Viral exanthems are typically erythematous macules and papules in a child with a prodrome of upper respiratory infection symptoms, fever, and/ or gastrointestinal symptoms. The majority of viral exanthems will be non-specific for a particular virus. There are a few viruses that have a classic rash description as well as commonly associated signs and symptoms.  Erythema infectiosum or fifth disease due to Parvovirus B19 may cause a “slapped cheek” appearance with a lacy reticular rash. Roseola infantum also known as exanthem subitum typically occurs in children 6 months to 3 years of age and is characterized by 3-5 days of high fevers followed by a macular papular rash that occurs after the fever subsides.

 

Erythema infectiosum: note the bright red cheeks or “slapped cheeks” 
Pictures from Wikimedia. org

 

Hand Foot and Mouth Disease (HFMD)

HFMD is a viral exanthem most often caused by group A and B coxsackieviruses and enterovirus 71 in the late summer and early fall. Typically the child will be febrile with URI symptoms. The hallmark exanthem noted with HFMD are vesicles and small shallow ulcerations on an erythematous base in the oral cavity, palms and soles. Oral lesions will be located on the uvula, palate, tonsillar pillars, buccal mucosa, and tongue and can be painful. Apart from the palms and soles, other cutaneous lesions may occur around the mouth, buttocks, perineum, elbows, knees, and lateral aspects of the hands and feet.  If the child only has oral involvement, the rash is termed herpangina.  Diagnosis is made clinically. Treatment includes supportive care, analgesics for pain, antipyretics, and oral rehydration. In certain cases, the oral painful lesions may lead to dehydration requiring intravenous hydration.

A.

B.

Picture A: HFMD rash of the feet
Picture B: Perioral HFMD rash
Pictures from Wikimedia.org


Non-infectious rashes in well appearing child

Erythema Toxicum

Erythema Toxicum is a benign rash of unknown etiology that occurs in 50% of full term newborns. Typically the rash will erupt 24-48 hours after birth and may last up to 7 days. The rash is described as erythematous blotchy patches with an associated papule, pustule or vesicle. The rash typically spares the palms and soles. Diagnosis is largely made clinically. A Wright stain of the vesicle or pustule’s fluid will reveal largely eosinophils. No treatment is needed other than reassurance.

Transient Neonatal Pustular Melanosis

Transient Neonatal Pustular Melanosis may affect up to 5% of African American/ black infants. At birth, pustules are noted in various areas of the body including the palms and soles. Ruptured pustules will leave a hyperpigmented macule often with a scaly rim. Diagnosis is largely made clinically. A Wright stain of the pustule’s fluid will reveal largely neutrophils. No treatment is needed other than reassurance. The pustules will typically resolve in several days whereas the hyperpigmented macules will subside in 3-4 months.

Pityriasis Rosea

Pityriasis Rosea is a papulosquamous (papules and scales or scaly papules and plaques) rash that is self-limited. A herald’s patch is the initial lesion seen in 80% of patients and will have similar features of tinea corporis in that it is an oval or circular erythematous patch with central clearing and a scaly rim.  Within 2-4 weeks, the heralds patch will be followed by an eruption of erythematous papules and oval plaques with scales typically located on the torso. On the back, the rash has a “Christmas tree” distribution, refer to picture. The oval plaques long axis will be parallel to the lines of skin stress. Of note, in children with a darker complexion pityriasis rosea will have different features.   The rash may be more papular with few plaques as well as there may be an inverse distribution of the rash involving the neck, proximal extremities, groin and axillae rather than the torso. The rash may be pruritic. There is no specific treatment.  Exposure to sunlight may hasten the resolution of the rash

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B.

Pityriasis Rosea
Picture A: Herald’s patch-note erythematous patch with central clearing
Picture B: “Christmas tree” distribution of erythematous plaques
Pictures from Wikimedia.org

A.

B.

Pityriasis Rosea In African American Child
Note scaly papules and plaques 
Pictures courtesy of Dr. S Margaret Paik 


Pearls and Pitfalls:

  • The appearance, distribution and associated symptoms are paramount in figuring out the etiology of a rash
  • Recognizing an ill-appearing versus a well-appearing child is paramount when considering a life-threatening rash.
  • Rashes that are life-threatening such as meningococcemia, TEN, SJS, herpetic lesions involving the eye, widespread eczema herpeticum, urticarial rash with anaphylaxis require timely recognition and intervention
  • Urticaria with no other associated symptoms or signs is often benign and requires symptomatic care
  • When urticaria is associated with hypotension, persistent GI symptoms, and/or respiratory signs a diagnosis of anaphylaxis should be considered
  • Children with suspected HSP should be screened for renal involvement with a urinalysis, serum renal function determination and blood pressure monitoring
  • Tinea corporis can be treated by a topical antifungal whereas tinea capitis is treated by an oral antifungal
  • Viral exanthems are typically non-specific and usually require supportive care

References

  1. Campbell RL, Li JT, Nicklas RA et al. “Emergency Department Diagnosis and Treatment of Anaphylaxis: a Practice Parameter”.  Ann Allergy Asthma Immunology 113 (2014) 599-608.Print.
  2. Kane, Kay Shou. Color Atlas & Synopsis of Pediatric Dermatology. New York: McGaw-Hill Medical, 2009. Print.
  3. Krowchuk, Daniel P and Anthony J. Mancini. Pediatric Dermatology: A Quick Reference Guide. 2nd Elk Grove Village, IL: Section of Dermatology AAP Section of Dermatology, American Academy of Pediatrics, 2012. Print.
  4. Lanzkowsky S, Lanzkowsky L., “Henoch-Schoenlein Purpura”. Pediatrics in Review. 13 (1992) 130-137. Print
  5. Weston, William L. and Alfred T. Lane. Color Textbook of Pediatric Dermatology. 1st St. Louis, MO: Mosby Year Book,1991. Print.

90,000 photos, symptoms in children and adults, treatment

What is scarlet fever

Scarlet fever is a serious infectious disease caused by a bacterium – group A hemolytic streptococcus.

Children 3-10 years old suffer from scarlet fever in more than 90% of cases. In adults, scarlet fever is easier than in children – it is manifested by an increase in body temperature up to 38 degrees, signs of sore throat and a pale rash. The infection affects only those adults who have a severely weakened immune system.

Scarlet fever is transmitted by airborne droplets (through saliva and mucus when sneezing, coughing), as well as by household means – through a common dish, towel, etc.

Sources of infection – a sick person, a person who has had scarlet fever (convalescent) and a healthy person – see the section “Causes of scarlet fever, source of infection and transmission routes”).

Symptoms of scarlet fever develop 2-12 days after infection (incubation period). During this time, streptococci rapidly multiply on the mucous membrane of the oropharynx and secrete erythrotoxin – a poison that destroys red blood cells.As a result, intoxication forms and symptoms of scarlet fever appear: an increase in body temperature up to 39 degrees, severe weakness, nausea, headache, muscle aches, redness of the tongue, signs of sore throat, enlargement of the cervical and occipital lymph nodes, as well as a specific rash throughout the body, mainly on the cheeks, on the lateral surfaces of the body, in the groin.

Scarlet fever is diagnosed and treated by a family doctor, pediatrician, infectious disease specialist. The diagnosis is established during examination (characteristic rash, specific changes in the tongue), as well as changes in the general blood test – leukocytosis, accelerated ESR, anemia.

Scarlet fever is treated with tableted antibiotics of the penicillin series. In case of severe intoxication, saline and colloidal solutions are injected intravenously.

Without treatment or with untimely improper treatment, scarlet fever is complicated by tracheitis, pneumonia, rheumatism, arthritis, myocarditis, glomerulonephritis, otitis media and lymphadenitis.

After recovery, strong immunity is developed – a recurrent scarlet fever occurs in 3% of cases – in people with severely weakened immunity.Repeated scarlet fever is much easier than primary.

There is no vaccine against scarlet fever, so the prevention of scarlet fever comes down to isolating the sick and convalescents, observing the rules of personal hygiene, and strengthening immunity.

Causes of scarlet fever, sources of infection and modes of transmission

As mentioned above, the causative agent of scarlet fever is group A hemolytic streptococcus. In addition to scarlet fever, group A hemolytic streptococcus causes arthritis, glomerulonephritis, erysipelas, rheumatism.

There are 3 sources of infection:

  • people with scarlet fever, angina, streptococcal pharyngitis. The patient is dangerous throughout the entire period of the rash; especially the first 3 days;
  • convalescent – a person who recovered from scarlet fever, but secretes streptococcus for another 3 weeks;
  • healthy person (healthy carrier or person with immunity to scarlet fever) – in whom hemolytic group A streptococcus lives in the nasopharynx and is excreted.

Ways of transmission of infection – airborne (through mucus and saliva when sneezing, coughing), as well as household (through common dishes, a towel, unwashed hands and even a doorknob).

Symptoms of scarlet fever in children and adults

The incubation period of scarlet fever – up to 12 days; most often 10 days.

The disease begins acutely. Here are the first symptoms of scarlet fever in children:

  • increase in body temperature to 39 degrees;
  • nausea, occasionally vomiting;
  • 90,031 headache; severe weakness;

    90,031 muscle aches and muscle pain;

  • sore throat, passing into other signs of sore throat; enlargement of the cervical and occipital lymph nodes;

As a rule, the next day after the first symptoms, indicative signs of scarlet fever are formed: a “raspberry” tongue and a rash.

“Raspberry tongue” – characteristic changes in the tongue, expressed in its sharp redness (the mucous membrane of the tongue becomes crimson) and an increase in the size of the papillae of the tongue.

Rash with scarlet fever – small punctate. It can be all over the body, but most often it is formed on the cheeks, groin and on the lateral surface of the body. When sprinkling on the cheeks, the nasolabial triangle remains pale. The rash thickens if it is located on the cheeks, in the axillary, elbow and popliteal region. When pressed with a spatula, the rash becomes golden yellowish.

The rash begins to fade after 5-7 days without skin pigmentation. In 20% of cases, scarlet fever occurs without a rash.

2 weeks after the onset of the disease, peeling of the skin appears on the fingers, palms, feet, trunk, neck and ears.

Symptoms of scarlet fever in children and adults are similar, but in adults the disease is much easier than in children. In half of cases, scarlet fever in adults occurs in the form of mild ARVI, without a rash.

Complications of scarlet fever

Without treatment, with improper / delayed treatment, after a severe course of scarlet fever is complicated by pneumonia, rheumatism, arthritis, myocarditis, glomerulonephritis, erysipelas, otitis media, lymphadenitis.

Diagnosis of scarlet fever

Scarlet fever is diagnosed by a family doctor, pediatrician, infectious disease specialist. The doctor examines the patient – reveals characteristic changes in the tongue and a rash on the face and body.

Changes in the general blood count are very pronounced, but not specific: leukocytosis and accelerated ESR. In severe cases, anemia is formed due to massive destruction of red blood cells.

In doubtful cases, the level of antibodies to streptococcus antigens is determined in the blood serum, which increases with scarlet fever.In children, a swab is taken from the oropharynx, followed by culture on a nutrient medium.

When making a diagnosis, scarlet fever should be distinguished from other diseases with similar symptoms: measles, rubella, mononucleosis, dermatitis, streptoderma, ARVI, meningitis, tonsillitis, etc.

Treatment of scarlet fever

Scarlet fever in most cases is treated at home. The patient is admitted to the hospital only for severe scarlet fever and its complications.

Prescribe diet number 2 – easily digestible dry / semi-liquid food.Shown a plentiful warm drink: freshly squeezed fruit juices, tea with lemon, milk with honey, etc.

Hemolytic group streptococcus is a bacterium, therefore the infection is successfully treated with antibiotics. For the treatment of scarlet fever, tablet forms of penicillin antibiotics are used: retarpen, phenoxymethylpenicillin, amoxicillin for 7-10 days.

In case of severe intoxication, intravenous infusion of saline and colloidal solutions is indicated.

Prevention of scarlet fever

There is no specific prophylaxis for scarlet fever – a vaccine for scarlet fever has not yet been invented.Therefore, for the prevention of scarlet fever, nonspecific measures are required:

  • isolation of sick people and convalescents;
  • compliance with the rules of personal hygiene;
  • Strengthening the immune system.

Which doctor to contact

If you suspect scarlet fever, immediately consult your family doctor, pediatrician, infectious disease specialist. Contact the doctors of the Botkin.pro medical video consultation service. See how our doctors answer patients’ questions.Ask a question to the doctors of the service for free, without leaving this page, or here. Consult the doctor you like.

Careful, scarlet fever !!!

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Scarlet fever

Scarlet fever is an infectious disease characterized by angina with lymphadenitis, general intoxication, fever, small-dot rash with further lamellar skin scaling. Refers to childhood diseases, in adults it is extremely rare. Scarlet fever in children occurs most often between the ages of 2 to 6-7 years.

Scarlet fever in children: symptoms

The incubation period of scarlet fever: from 1 to 12 days, usually from 3 to 7. The disease begins acutely. The general condition of the sick person is deteriorating rather quickly. Together with the chills, the temperature rises quickly, which already in the first hours reaches 39 – 40 ° C, such a temperature can last for 3 – 5 days. With mild forms of the disease, vomiting can be single, with severe – multiple, persistent.Some children may experience irritation, delirium, anxiety, insomnia, convulsions. Others have drowsiness, apathy, lethargy. Scarlet angina is associated with a sore throat, there is a bright hyperemia, which has a clear border along the edge of the palate. The tonsils are greatly enlarged, loosened. Scarlet fever in children has its own specific symptom; a yellow-white plaque forms on the surface of the tonsils and tongue. This plaque disappears after 5 days from the moment of infection. Together with the plaque, the filiform papillae of the tongue peel off, a smooth surface of bright red color is exposed, against which the mushroom papillae of the tongue are visible.This symptom is called Raspberry Tongue .

The main distinguishing symptom of scarlet fever.
Raspberry tongue

The first signs of scarlet fever also include necrosis (necrosis), which can be found on the tonsils in the first 3-4 days of illness. Necrosis extends to the uvula, palatine arch, pharyngeal wall and soft palate. They quickly penetrate the tonsils. The mucous membrane around the necrosis takes on a bright red hue.

With a lesion of the nasopharynx, symptoms of necrotizing nasopharyngitis are observed, that is, nasal breathing is difficult, purulent mucus is released from the nose, cracks and redness are formed around the nasal openings.Possible inflammation of the paranasal cavities, mastoiditis, otitis media. Necrotizing tonsillitis is accompanied by pain when swallowing and bad breath. Scarlatinal lymphadenitis is characterized by compaction, enlargement, soreness of the upper cervical nodes. The likelihood of developing purulent lymphadenitis or phlegmon is not excluded. Tongue covered with off-white dry coating.

Rash with scarlet fever

The rash is one of the most typical symptoms that scarlet fever has.It appears literally in a couple of hours, and maybe on the 2nd or 3rd day of illness. First, the rash covers the neck and upper body, and then very quickly spreads to the entire face, trunk and limbs. The nasolabial triangle remains unaffected by the rash. A scarlet fever rash begins as small red spots with a bright color in the center and fades towards the border. The spots are located very densely, merging with each other and creating a picture of continuous erythema. If you lightly press on a speck, it disappears, but a white speck forms in its place.White dermographism is clearly formed, which is better manifested in milder forms of the disease.

On the patient’s skin, multiple wounds are possible – scratching, since the rash is accompanied by itching. The skin is very dry, with a bright red rash – rough. The rash is more pronounced in the articular folds and folds. With a bright rash in the folds, punctate hemorrhages are found. Sometimes small bubbles filled with a clear or cloudy liquid may appear.

Scarlet fever passes into the second period, starting from the 4-5th day, when the first signs disappear.The temperature gradually returns to normal, the state of health improves. On the 4-5th day, the tongue acquires a bright red color with a raspberry tint and swollen papillae, on the 9-10th day it acquires a completely natural look. Sometimes this sign is weak or absent altogether. The rash becomes pale, takes on a brownish tint. Pigment stripes are present in the articular folds of the skin for several days. After the rash has completely disappeared, peeling of the skin begins, peeling lasts 2-3 days, starting from the neck, moving to the chest, face, trunk, on the face the peeling is very small, and while the body is covered with larger scales.Then the process of peeling spreads to the auricles, ending with the limbs, where the epidermis falls off in wide layers, especially on the palms and soles. Children under 2 years of age may not have peeling.

There are some peculiarities associated with changes in blood composition. Already from the first days of the disease, an increase in the number of leukocytes is observed, neutrophilia is noted (from 60-70 to 90). From the 3rd day, the number of eosinophils increases (sometimes up to 15-30%). The maximum eosinophilia occurs at the end of the first week.But in severe forms of the disease, it may be absent altogether. There is a decrease in erythrocytes and hemoglobin, an acceleration of erythrocyte sedimentation (20-50 mm / h).

Scarlet fever in children has three degrees:

  1. – mild,
  2. – medium,
  3. – severe.

The main distinguishing features of a mild form are mild intoxication, a slightly disturbed general condition of the patient, a slight and short-term fever. Angina is repressive.With a mild form of the disease, the rash is typical, but scanty, moderate lymphadenitis. There are small changes in the periphery of the blood. The mild form is the so-called erased scarlet fever, the symptoms of which are mild and short-lived, however, some of them may not be present.

The following symptoms are characteristic of the average form of scarlet fever: intoxication, high temperature (up to 39 ° C), tachycardia, repeated vomiting, tonsillitis with a white-yellow coating. The rash with an average form of the disease is bright, profuse.

Rashes and tonsillitis

A severe form of the disease is diagnosed by a combination of pronounced standard symptoms with symptoms of a toxic and septic nature. Here the temperature increases to 40 ° C and more, lymphadenitis with periadenitis, tonsillitis with the spread of necrosis to the soft palate and nasopharynx appear. The rash is profuse, hemorrhagic. Very often, streptococcus is found in the blood, causing septicopyemic metastases. In severe cases, hematological changes are clear, pneumonia, myocarditis (damage to the heart muscle), enlargement of the spleen and liver, septic endocarditis (inflammation of the inner lining of the heart), glomerulonephritis (kidney disease) are possible.The severe form includes hypertoxic scarlet fever, in which intoxication develops very quickly before the appearance of typical signs of the disease.

Scarlet fever in adults and causes of scarlet fever

The causative agent of the infection is beta-hemolytic streptococcus (Streptococcus pyogenes). The infection is transmitted by airborne droplets. The source of infection is a person who is sick with scarlet fever or any other disease that is caused by beta-hemolytic streptococcus (erysipelas, nasopharyngitis, tonsillitis), a bacillus carrier.The incubation period for scarlet fever: 7 – 10 days. As mentioned earlier, the infection is transmitted by airborne droplets, however, the transmission of the pathogen is also possible through objects (clothes, toys). Scarlet fever in children occurs between the ages of 2 to 6-7 years, at this age children are most susceptible to this disease. Scarlet fever in adults may appear if they were not sick in childhood. As with other “air” infections, the peak incidence of scarlet fever occurs in winter and autumn. Disease leaps recur every 5 to 7 years.A person who has had scarlet fever acquires lifelong immunity, that is, he cannot get sick a second time.

The gates of infection are the palatine tonsils. Inflammatory-necrotic changes are observed at the site of infection. The causative agent of the disease enters the lymph nodes through the blood and lymph tracts, causing lymphadenitis (inflammation of the lymph nodes).

Treatment of scarlet fever

With a mild form of scarlet fever, treatment is carried out at home.In the case of moderate and severe forms, the sick should be treated in an infectious diseases hospital. Hospitalization is carried out in separate wards when they are instantly filled (to exclude cross-infection). Regardless of the severity of scarlet fever, patients should receive antibiotics for 5-7 days. Symptomatic therapy is prescribed, a diet that corresponds to the age of the patient and enriched with vitamins with the exception of spicy, salty and fried foods. For the first 5-7 days, it is important to stay in bed, gradually switching to a general one.Discharge is made after the disappearance of the clinical manifestations of the disease.

Prevention of scarlet fever

With scarlet fever, active immunization is not carried out. Young children and those who were first in contact are injected with 3-6 ml of gamma globulin. In children’s institutions, from the moment of isolation of the patient, quarantine is established for 7 days. Those who have been ill are admitted to the team 2 days after the onset of the disease, discharged from the hospital – 12 days after the end of the isolation period.Scarlet fever, although an unpleasant disease, does not arise in the prevention and treatment of problems.

Scarlet fever.

Scarlet fever is an acute infectious disease, which is accompanied by severe angina, symptoms of general intoxication of the body, and skin rashes. Most often children get sick with scarlet fever at the age of 1 – 9 years. For the first months of life, children never get sick with scarlet fever, because they still have protective antibodies received from their mothers in their bodies.In the article, we will consider what scarlet fever symptoms are during the treatment of the quarantine conditions.

Scarlet fever – symptoms, course of the disease.
The causative agent of scarlet fever – hemolytic streptococcus – enters the mucous membranes and multiplies vigorously in the baby’s throat, which becomes bright red. The baby has symptoms of sore throat. Then, gradually, the child’s skin becomes a bright red color, against the background of which a small-dot continuous rash spreads all over the baby’s body, not affecting only the skin around the mouth.This is the main symptom in the diagnosis of scarlet fever: a profuse rash on red skin combined with pale skin around the mouth.
The disease of scarlet fever is very contagious, contagious, the susceptibility of children to it is very high. Most often, children with a history of diathesis, chronic inflammatory and infectious diseases, diseases of the nasal cavity and mouth, and throat get sick with scarlet fever.
The situation is aggravated by non-compliance with sanitary and hygienic standards in rooms, families and children’s groups, stuffy, unventilated rooms, insufficient nutrition for children, and the lack of vitamin products in the diet.
Most often, scarlet fever is observed in spring and autumn outbreaks.
You can become infected with scarlet fever from a sick child, or from someone who has just had a disease. Scarlet fever is highly contagious, and infection is possible through contact with a patient with scarlet fever, when using his things, through toys, household items, food.
The incubation period for scarlet fever is most often 2-4 days after contact, but sometimes it can last up to 11 days.
In most cases, children recover completely.Some children may develop complications, even after the main symptoms of the disease have already passed. Complications can occur with the mildest forms of scarlet fever, and with severe ones, they do not appear. The nature of the course of the disease does not affect the occurrence of complications.
Complications of scarlet fever, which significantly worsen the prognosis of the disease, are lymphadenitis, diseases of the heart, blood vessels, kidneys, and middle ear.
Scarlet fever – quarantine conditions.
A child with suspicions of scarlet fever, in any case – it proceeds easily or hard – is placed in an infectious box of a hospital, or isolated at home, if possible.If a child has signs of a worsening condition, or the development of complications, he is placed in the infectious diseases department under the constant supervision of doctors.
At home, strict quarantine rules must be followed: the child must be in a separate room. A sick child should have their own dishes, bedding, linen, toys, hygiene products – a towel, a toothbrush, handkerchiefs. The patient’s belongings must be boiled, and then ironed with a hot iron.You cannot wash the things of a sick child with the things of other family members. Toys and hygiene products must be thoroughly washed with soapy water, treated with disinfectant solutions.
A family member should take care of the sick child. When in contact with a child, he must wear a dressing gown, when leaving the patient’s room, take off the dressing gown and leave it in the room. The dressing gown is washed in the same way as the patient’s belongings – with boiling and ironing.
During the entire period of the disease, the patient should never contact other family members, especially children, in order to avoid the spread of the scarlet fever epidemic.
The room of a sick child must be ventilated – the patient needs fresh air. It is necessary to provide complete peace and quiet for the child.
In the first seven days from the onset of the disease, the patient is prescribed bed rest, and then they look at the child’s condition. The patient can, after a week from the onset of the disease, get out of bed, play, walk around the room, if he has no complications of the condition.
The child should not be forced to take food, especially for the first days – he should eat when he wants, and as much as he wants.It is necessary to water the baby, but not in large quantities, so as not to induce vomiting, but in small sips, often.
You need to feed a sick child with milk porridge, vegetable and meat purees, mashed soups, soufflés, give milk, jelly (especially good – cranberry), compotes, rosehip broth. Be sure to give the child raw fruits and berries. Later, when the disease has already subsided, the baby should receive a more varied diet, with meat and fish dishes.
A sick child should be treated on the recommendation of a doctor, which must be carefully followed.In no case should you self-medicate!
Quarantine for a sick baby should last 10 days – both at home and in the infectious diseases ward. Children who attend kindergarten or the first two grades of school, after the main quarantine, are quarantined to visit a childcare facility for another twelve days – to prevent the spread of the scarlet fever epidemic.
For children who have been in contact with the sick, medical supervision is established, for kindergartens and schools, quarantine is established for visiting a children’s institution for a period of a week.
Children who are in the family of a sick child must comply with quarantine for another week after the end of the acute period of the disease in a sick child.
Adults from the patient’s family who have contact with childcare facilities, food facilities, also observe quarantine for 1 week after an acute period of illness in a child. All this time, they must be under the supervision of doctors.
In the article, we examined what scarlet fever symptoms are during the treatment of a quarantine condition.Weakened children with a second contact with a patient with scarlet fever can get sick again.

Rash with scarlet fever: photo, therapy, prevention of the disease

Does a rash always occur with scarlet fever, how to treat this unpleasant disease and what are its features? We will answer these and other questions regarding the mentioned disease below.

Basic information about the infectious disease

The causative agent of scarlet fever is hemolytic streptococcus belonging to group A.It causes an infectious disease, which manifests itself in the form of fever and general intoxication. Also, a rash with scarlet fever almost always occurs. It should be especially noted that the main clinical manifestations of this disease are not caused by the streptococcus itself, but by the toxin released into the blood. The source of spread of the mentioned infection is a person. You can get infected with such a disease pretty quickly.

Features of an infectious disease

The causative agent of scarlet fever that affects a person often provokes the occurrence of tonsillitis or streptococcal pharyngitis.Such a patient is especially dangerous for the people around him in the first days of the illness. A person who has successfully recovered from the disease in question is called a convalescent. It should be remembered that for some time he is able to secrete streptococcal infection. Typically, such a carrier lasts up to three weeks. During this period, you should minimize any contact with people around you.

A healthy carrier is a person who has no symptoms of the disease, but group A streptococci live on the mucous membrane of his mouth and nasopharynx and are released into the surrounding atmosphere.It should be noted that there are a lot of such people (about 15% of the total population of the Earth).

What are the causes of the disease?

Vaccination against scarlet fever effectively protects a person from contracting streptococcal infection. By the way, in addition to people with scarlet fever, the source of such a disease is a banal sore throat or any other carrier of streptococcus. As a rule, infection with this disease occurs through airborne droplets. Sometimes a person becomes ill with scarlet fever through everyday contact (for example, through the patient’s toys, household items, etc.).

It should be noted that infection with the infection in question can occur through any damage on the skin (for example, abrasions, cuts, during a surgical operation, etc.). In this case, the patient may experience a rash with scarlet fever, as well as other symptoms of the disease, except for sore throat.

The main signs of the disease

Vaccination against scarlet fever protects a person well, but, unfortunately, not everyone does such injections. When infected with the infection in question, its incubation period lasts about 1-12 days.This disease is characterized by a rather acute onset. The patient’s body temperature rises almost immediately to 39 degrees. At the same time, he has discomfort in the throat when swallowing, noticeable weakness and headaches.

On personal examination of the patient’s oropharynx, the doctor discovers the classic clinical picture of angina. By the end of the first day of the disease, a punctate and rather profuse rash appears in the upper body and on the neck of the patient. With scarlet fever, this irritation occurs very often.It is a group of rashes that protrude above the level of the skin and, merging with each other, form red specks 1-1.8 mm in size. Such unpleasant irritation spreads very quickly throughout the patient’s body.

Localization of the rash with scarlet fever is different. However, it is most intense in the armpits, as well as in the elbows and skin folds. Quite often, such irritation on the skin is accompanied by unbearable itching. The nature of the rash with scarlet fever is profuse, punctate.As a rule, this irritation lasts 2-3 days and then gradually disappears.

Other symptoms of scarlet fever

What other symptoms are characteristic of a disease such as scarlet fever (photo is presented in this article)? According to experts, the face of an infected person begins to “glow”, but around the mouth and nose (nasolabial triangle) remains pale, with intact skin. Under the influence of toxins, the patient’s tongue acquires a rich red color, and also becomes covered with protruding papillae.

The human body temperature remains elevated for about 2-4 days, after which it gradually drops. From the 5-6th day of the disease, intense peeling occurs at the site of the rash, which lasts for 2-3 weeks. Scarlet fever (you can see photos of patients below) is diagnosed very easily. Usually the doctor makes a diagnosis at home, based on the clinical picture of the disease.

Can complications occur if left untreated?

Scarlet fever without rash may occur.In this case, the disease is more severe. As a rule, it is manifested by the development of necrotizing tonsillitis, and is also accompanied by early purulent complications.

According to experts, complications of scarlet fever are divided into 2 groups: early and late. The first are associated with an infectious infection of neighboring tissues. In this case, otitis media, sinusitis, etc. may develop. As for late complications, they are due to the development of immune disorders such as glomerulonephritis, rheumatism, etc.By the way, the most severe and dangerous late allergic complications of scarlet fever occur with improper treatment of the disease.

How to deal with pathology?

Most often, scarlet fever is treated at home. Only those patients who have moderate and severe forms of the disease are subject to hospitalization. In addition, patients with children from 3 months to 7 years old, as well as schoolchildren of the first two grades who did not suffer from scarlet fever, are sent to the hospital.

To eliminate the symptoms of this infectious disease, doctors usually prescribe antibiotic therapy using penicillin drugs.This intensive treatment is continued for 5-7 days. In the event that the patient cannot tolerate penicillin, other antibiotics are used.

What to do for the patient

When observing all the symptoms of scarlet fever, the patient should immediately call a doctor. After the diagnosis is made, the doctor will prescribe antibiotic therapy. In this case, the patient should strictly adhere to all his recommendations. Otherwise, he may have rather serious complications.

In addition to taking antibiotics, the patient is required to comply with bed rest.This should be done until the body temperature is completely reduced. Also, the patient is shown to drink plenty of fluids in order to prevent toxic complications. The food of a patient infected with scarlet fever must be semi-liquid or liquid. He also needs to limit his protein intake.

Prevention of disease in children and adults

As mentioned above, the infectious disease under consideration can be transmitted to a healthy person by airborne droplets, as well as through household items. Therefore, a patient with scarlet fever must necessarily be isolated in a separate room.Such a patient should be provided with their own personal hygiene products, including a towel. He is also given separate tableware. Experts say that the isolation of the patient can be stopped immediately after his recovery, but not earlier than ten days after the onset of the disease.

Children who have had scarlet fever are allowed to attend the first two classes of schools and kindergartens only after their additional isolation at home for 12 days after recovery.As for the babies who did not suffer from scarlet fever, but were in contact with the infected, they are not allowed into the team for 7 days from the moment the patient was isolated. By the way, with direct communication with the patient during the progression of his illness, this period should be 17 days from the beginning of the first contact.

90,000 main signs of the disease. How scarlet fever proceeds. Scarlet fever treatment

Scarlet fever is an acute infectious disease, the manifestations of which are a small-point rash against a background of redness of the skin, inflammation of the tonsils and general intoxication of the body, accompanied by fever.The rash with scarlet fever is most intense in places of natural folds of the skin, as well as on the lateral surfaces of the trunk and lower abdomen.

Scarlet fever – treatment at Family Doctor AO A characteristic feature of scarlet fever is the pale and rash-free skin of the nasolabial triangle (the area formed by the base of the nose bridge and the corners of the mouth), which stands out against the background of a general abundant rash.

Causes of scarlet fever

Scarlet fever

The causative agent of scarlet fever is one of the varieties of streptococcus.It also causes some other diseases – tonsillitis, erysipelas. Since the causative agent of the disease is the same, you can get sick with scarlet fever even after contact with patients suffering from these diseases. Streptococcus can be present in the body without manifesting itself as a disease. Carriers of an infection in such a “dormant” state can also be the source of the disease. But most often they get sick with scarlet fever, having become infected from other patients with scarlet fever. A patient with scarlet fever is contagious from the 1st to the 22nd day of the disease.

Most often, scarlet fever affects children aged 3 to 10 years attending preschool and school institutions. Children of the first year (especially in the first 6 months of life) and adults rarely get sick. The largest number of cases of the disease occurs in the cold, autumn-winter period.

The main route of transmission of the disease is airborne . However, streptococcus is very stable in the external environment. In sputum or pus, the causative agent of scarlet fever can exist for more than one and a half weeks.Therefore, a contact route of infection (for example, through things, dishes or toys), and alimentary (when eating food) is possible.

Symptoms of scarlet fever

The incubation period for scarlet fever is from 2 to 7 days. The onset of the disease is acute. The temperature rises (up to 38-39 ° C), the patient shivers, he has a headache, weakness is felt, there may be nausea or vomiting. At the same time, symptoms of sore throat appear – a sore throat when swallowing, on examination, inflamed and enlarged tonsils, a “flaming pharynx” (reddening of the soft palate and the back of the pharynx) are found.The tongue is covered with a white coating. However, on the 3rd – 4th day of the disease, the plaque disappears, the tongue acquires a crimson color, its surface becomes granular.

Rash

Quite quickly (by the end of the 1st or 2nd day of illness) a rash appears: even more red, numerous very small dots appear on the reddened skin. The rash covers the entire body, but is concentrated in places of natural folds of the skin, in the lower abdomen and on the sides of the body.The rash fades away after 3-7 days, leaving no pigmentation behind. After the rash disappears, the skin begins to peel off, and on the palms and feet it comes off in layers. This usually occurs on the 14th day of illness.

More about symptom

Methods for the treatment of scarlet fever

Currently, the treatment of scarlet fever, as a rule, is not a problem. However, left without proper treatment, scarlet fever is dangerous with complications, primarily from the cardiovascular system, kidneys and ENT organs.

After the transferred disease, in most cases, persistent lifelong immunity is developed. Re-ill with scarlet fever is rare – only when the immune system is dysfunctional. Immunity is developed specifically to scarlet fever; other streptococcal diseases after scarlet fever are possible.

If you find that your child has symptoms of scarlet fever, call a pediatrician at home.

Antibacterial therapy

Streptococcus is highly sensitive to antibiotics, so antibacterial treatment usually leads to a rapid improvement in the condition and, ultimately, to recovery.

Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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90,000 Scarlet fever – symptoms, routes of infection, treatment and prevention

Signs, treatment and prevention of scarlet fever

Scarlet fever is an infectious disease that occurs in an acute form and is characterized by a punctate rash, sore throat, general intoxication of the body.Signs of scarlet fever in children are always pronounced and therefore, in most cases, treatment begins in a timely manner. But if the infection proceeds latently or without intense manifestations, then serious complications are possible.

How the disease is transmitted

The causative agent of scarlet fever belongs to the group of streptococci, which can affect the kidneys, joints, palatine tonsils. If at the time of the penetration of the infection into the human body, the immune system is strongly weakened, then this disease develops.

The source of infection is a person who has scarlet fever or is a carrier of streptococci. The incubation period for scarlet fever lasts on average about 10 days. An infected person poses a danger to others in terms of the spread of the disease within 15-20 days after the first signs appear.

Scarlet fever can also be infected:

  • by airborne droplets;
  • through toys and household items;
  • through food.

Clinical manifestations

Scarlet fever always begins acutely:

  • body temperature suddenly rises to 39 degrees and above;
  • 90,031 children complain of severe headache and nausea;

  • the patient cannot swallow food (cutting pain in the throat).

On the third day after the first manifestations of the disease, a small rash appears on the body, characterized by severe itching. Knowing what a scarlet fever rash looks like can help you take urgent therapeutic steps.A characteristic feature of the disease is the rash “accumulates” in natural folds in the form of red stripes. It is necessary to carefully examine the groin folds, armpits and elbow folds, since pathological foci are most often found in these zones. To the touch, the skin with rashes becomes excessively dry, rough and resembles fine sandpaper. The rash can affect the face and entire body. A characteristic feature of scarlet fever is a clear nasolabial triangle.

The tongue of a patient with scarlet fever also changes, becoming crimson with swollen, bulging papillae.The entire mucous membrane of the oral cavity becomes inflamed and acquires a red tint, there is a purulent plaque on the tonsils. Doctors call this type of oral cavity “fiery mouth” and consider it to be one of the defining signs of the disease.

Only after four days (on average, an increase / decrease of this period by a day is allowed) the skin turns pale, active peeling of the lesions begins – the skin is removed with a “stocking”, especially on the palms.

Symptoms of scarlet fever in adults are identical, but the course of the disease is always more severe with a critical rise in temperature and seizures.

Treatment and prevention of scarlet fever

There is no answer to the question of how to treat scarlet fever at the initial stage, with an exact list of drugs – doctors recommend only symptomatic therapy. If the disease is mild, then the child is at home. Hospitalization is necessary if complications arise. Within 10 days, the patient must comply with bed rest, he is prescribed a course of antibacterial drugs to suppress the growth and spread of streptococcus in the body.To facilitate overall health, doctors additionally recommend:

  • rinsing the mouth with a decoction of chamomile medicinal or furacilin;
  • taking antihistamines to relieve itching in the areas of rashes;
  • a course of vitamin therapy to strengthen the immune system and to prevent complications.

Pediatricians and infectious disease specialists are engaged in the treatment and prevention of scarlet fever. Doctors of these specialties must not only diagnose the disease, differentiate it from sore throat and allergies to any drugs, but also observe the patient even after his recovery.In particular, it is necessary to monitor the characteristics of excreted urine and the condition of the joints, because the most frequent consequences of complications of scarlet fever in a child are glomerulonephritis and rheumatism. You can read more about possible complications on the pages of our website Dobrobut.com.

How many days is the quarantine for scarlet fever? Children and adults should be isolated for 10 days if the course of the disease is mild and without complications. But even after this period, they cannot visit crowded places (schools, offices, etc.) for another 12 days.Thus, isolation continues for at least 3 weeks.

Preventive measures

A patient with scarlet fever needs not only to allocate a separate room, but also separate dishes, towels and other household items. It is necessary to carry out wet cleaning 2-3 times a day in the room where the patient is, and it is advisable to do this with a special disinfectant solution (Whiteness is suitable for this at home).

If scarlet fever occurs in a kindergarten, then the entire institution is quarantined and even healthy children do not attend it for 3 weeks.But such risks are successfully controlled by compliance with sanitary and hygienic standards, regular checks of the sanitary station for the presence of streptococcus, wet cleaning with disinfectant solutions and monitoring the condition of children.

There is no vaccination against scarlet fever, but once having had it, a person becomes practically invulnerable to infection – the immune system produces specific antibodies. Thanks to modern antibacterial drugs and a high level of medicine, scarlet fever responds well to treatment and the prognosis for it is extremely favorable.

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Skin rash in children

Rash in children is a very common occurrence, and in most cases it goes away on its own a few days after detection. However, there are types of skin rashes that form under the influence of infections, allergens, and other disease-causing environments.

Parents should watch the rash for several days to see if it spreads throughout the body, if the skin is flaking, if the condition of the child changes.It’s time to sound the alarm if the child is restless, he has a fever, the rash does not disappear, but only reddens and itches. A dermatologist should examine the baby and identify the cause of the rash.

What are the types of rashes and their causes?

  • Allergy
    • Urticaria. Appears as large redness with a pale center. Occurs due to food allergies or drug allergies. Lasts about four days, can move through the body;
  • Localized infections
    • Impetigo. Streptococcus or staphylococcus bacteria enter the wound. Pus and moisture ooze from the wound, it becomes covered with yellow scabs. If a child scratches a wound, bacteria can spread to healthy areas of the body. Lasts about a week until it becomes dry and crusty. Can be treated with oral or topical antibiotics;
    • Infected wound. A scratch or wound gets germs from the outside. The wound becomes swollen, moisture oozes from it, sometimes pus. The child’s general condition worsens, and fever may begin.The lymph nodes in this area also swell;
    • Fungal rash. Caused by two types of fungi, candida and shingles. The most common diseases are ringworm, thrush in infants. Herpes zoster produces ring-shaped eruptions, and candida is whitish, often in the diaper area. You can get infected with fungal infections at any age, fungi are transmitted through a humid environment.
    • Cellulite. Streptococcus skin infection.The affected area of ​​skin becomes swollen and bright red. Sometimes this condition may be accompanied by fever;
    • Scabies. Caused by a scabies mite, localized in the armpits, between the fingers, in the area of ​​the wrist – where the female tick penetrates. It is characterized by itching, after which blisters and ulcers may occur. It is possible to identify scabies by small gray holes – mite burrows;
    • Pediculosis. Damage to the scalp by lice. Insects lay eggs on the hair, and the waste products of the lice cause severe itching on the scalp.They can be seen with a magnifying glass. It is quite simple to deal with lice, the main thing is to isolate the child from other children in time so that they do not get infected;
    • Warts;
    • Molluscum contagiosum. Molluscs are raised bumps of the skin. They can be gray, yellow or pink. No treatment is needed, they go away on their own;
    • Eczema and all its varieties;
    • Diaper rash.

Summing up, we note that the rash can be caused by more serious diseases: scarlet fever, chickenpox, mononucleosis, Lyme disease, roseola and acne.