The causative agent of scarlet fever is group A streptococcus, which can also cause kidney damage (glomerulunofrit), tonsillitis, chronic tonsillitis, rheumatism and other diseases. Scarlet fever occurs if at the time of infection with streptococcus there is no immunity to it.
The source of infection is a patient with scarlet fever, sore throat or a “healthy” carrier of stereptococci. The incubation period usually lasts from 1 to 10 days. The child is considered contagious the day before the onset of the first symptoms and in the next 2-3 weeks.
The infection is transmitted by airborne droplets (by sneezing, with kisses, etc.). In addition, you can become infected with scarlet fever through food, common dishes, clothes, or simply by holding on to the door handle, which until then had been opened by a completely healthy-looking carrier of infection.
Once on the mucous membrane, streptococcus causes inflammatory changes in the nasopharynx. The microbe produces a large amount of a toxic substance – erythrotoxin. Once in the bloodstream, this toxin destroys red blood cells and causes intoxication (poisoning of the whole organism). Under its action, in all organs, including the skin and mucous membranes, small vessels expand, which leads to the appearance of a characteristic rash. Erythrotoxin causes the death of the outer layer of the skin – the epidermis, which leads to severe peeling of the skin.
By the end of the first week of the disease, immunity to streptococcus begins to develop. The synthesis and accumulation of antibodies, their binding of toxins leads to a decrease and elimination of manifestations of toxicosis and the gradual disappearance of the rash.
How is it manifested?
Scarlet fever begins acutely: with a sharp rise in temperature to 39º C. The child complains of headache, nausea, severe malaise, severe pain when swallowing.
At the end of the first beginning of the second day, a small, itchy rash appears that in a few hours covers almost the entire body. An important sign of scarlet fever is a thickening of the rash in the form of dark red stripes on the skin folds in places of natural folds – in the inguinal folds, axillary hollows, elbow folds. The skin is very dry to the touch and resembles sandpaper.
If you look into the patient’s mouth, you can see the bright red inflamed mucosa, purulent deposits on the palatine tonsils and raspberry tongue with sharply enlarged papillae. Doctors describe this condition of the throat with the expression “flaming pharynx”.
On the face, the rash is located on the cheeks, to a lesser extent on the forehead and temples, while the nasolabial triangle remains pale and free from the elements of the rash (a characteristic sign of scarlet fever).
After 3-5 days, the skin turns pale and severe peeling begins, especially expressed on the baby’s hands: the skin is removed from them like gloves.
lymphadenitis (damage to the lymph nodes);
purulent otitis media (ear inflammation);
allergic kidney disease – glomerulonephritis,
joint inflammation – arthritis, synovitis;
heart damage – allergic myocarditis;
The likelihood of complications is significantly reduced when taking a full course of antibiotics.
After suffering scarlet fever, as a rule, lifelong immunity is preserved. However, re-infection of scarlet fever does occur. Doctors are convinced that this is the fault of too active therapy – the disease is neutralized so quickly that the immune system does not have time to form.
Diagnosis and treatment
The diagnosis is made on the basis of data on contact with a patient with scarlet fever, tonsillitis, in the presence of a characteristic rash and a throat lesion.
Treatment is usually done at home. Children with severe and complicated forms of scarlet fever are hospitalized.
Within 7-10 days, bed rest is necessary. To suppress the growth of streptococcus, antibiotics are used in a 10-day course. In addition, a gargle is prescribed with a solution of furatsillin, infusions of chamomile, calendula, eucalyptus. Also used antiallergic drugs, vitamins.
The forecast is favorable.
After recovery, it is necessary to carefully monitor the well-being of the child, the color of urine (with glomerulonephritis, the urine becomes the color of “meat slops”, which is associated with the release of blood), pay attention to the appearance of pain in the joints. This will allow you to identify and begin treatment of complications of scarlet fever in time.
Children who have been in contact with a patient and who have not previously had scarlet fever are admitted to a preschool institution or to the first two classes of a school after seven days of isolation at home. In the apartment where the patient is, carry out regular wet cleaning, airing the premises.
There is no vaccine for scarlet fever.