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Anonymous
Anonymous asked in HealthDiseases & ConditionsInfectious Diseases · 1 decade ago

What's scarlet fever?

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  • Anonymous
    1 decade ago
    Favorite Answer

    Scarlet fever is a disease caused by an exotoxin released by Streptococcus pyogenes. It is characterized by sore throat, fever, a 'strawberry tongue', and a fine sandpaper rash over the upper body that may spread to cover almost the entire body. Scarlet fever is not rheumatic fever, but may progress into that condition. The rate of development of rheumatic fever in individuals with untreated streptococcal infection is estimated to be 3%. The rate of development is far lower in individuals who have received antibiotic treatment.

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    Cause

    Streptococcus pyogenes Bacterium (group A streptococcus) is responsible for scarlet fever. It can also cause simple angina, erysipelas, and serious toxin-mediated syndromes like necrotizing fasciitis and the so-called streptococcal toxic shock-like syndrome. The virulence of group A streptococcus seems to be increasing lately. The exanthem, or widespread rash, of scarlet fever is thought to be due to erythrogenic toxin production by specific streptococcal strains in a nonimmune patient. Besides erythrogenic toxins, the Group A streptococcus produces several other toxins and enzymes. Two of the most important are the streptolysins O and S. Streptolysin O, an hemolytic, thermolabile and immunogenic toxin, is the base of the anti-streptolysin O titer, an assay for scarlet fever and erysipelas.

    History

    This disease was known before the twentieth century as scarlatina (from the Italian scarlattina). Since the middle of the twentieth century the disease has, for reasons which are not understood, become much milder in its effects, and the usage of the name scarlatina has now replaced the term "scarlet fever" in some areas.[1]

    Many novels depicting life before the nineteenth century (see Scarlet fever in popular culture below) describe scarlet fever as an acute disease being followed by many months spent in convalescence. The convalescence was probably due to complications with rheumatic fever or even due to the treatments tried. Prior to an understanding of how streptococcus was spread and modern medicine, it was also not uncommon to destroy or burn the personal effects of a person afflicted with scarlet fever to prevent transmission to other people.

    The flushed cheeks and paleness around the mouth of scarlet fever.

    The scarlet fever rash.Early symptoms indicating the onset of scarlet fever can include Fever of 37 to 40 degrees C.(101-104 degrees F.)

    Fatigue

    Sore throat

    Headache

    Nausea or Vomiting

    Abdominal pain

    Flushed face with paleness around the mouth (perioral pallor, circumoral pallor)

    Tachycardia (rapid pulse)

    Lymphadenopathy (enlarged lymph nodes)

    Punctate red macules on the hard and soft palate and uvula (Forchheimer spots).

    Bright red tongue with a "strawberry" appearance

    Characteristic rash, which:

    is fine, red, and rough-textured; it blanches upon pressure

    appears 12–48 hours after the fever

    generally starts on the chest, axilla (armpits), and behind the ears

    is worse in the skin folds

    Pastia lines (where the rash becomes confluent in the arm pits and groins) appear and persist after the rash is gone

    The rash begins to fade three to four days after onset and desquamation (peeling) begins. "This phase begins with flakes peeling from the face. Peeling from the palms and around the fingers occurs about a week later and can last up to a month."[3] Peeling also occurs in axilla, groin, and tips of the fingers and toes.[2]

    Diagnosis of scarlet fever is clinical. The blood tests shows marked leukocytosis with neutrophilia and conservated or increased eosinophils, high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and elevation of antistreptolysin O titer. Blood culture is rarely positive, but the streptococci can usually be demonstrated in throat culture. The complications of scarlet fever include septic complications due to spread of streptococcus in blood and immune-mediated complications due to an aberrant immune response. Septic complications, today rare, include ear and sinus infection, streptococcal pneumonia, empyema thoracis, meningitis and full-blown sepsis, upon which the condition may be called malignant scarlet fever.

    Immune complications include acute glomerulonephritis, rheumatic fever and erythema nodosum. The secondary scarlatinous disease, or secondary malignant syndrome of scarlet fever, includes renewed fever, renewed angina, septic ear, nose, and throat complications and kidney infection or rheumatic fever and is seen around the eighteenth day of untreated scarlet fever.

    Treatment

    Other than the occurrence of the diarrhea, the treatment and course of scarlet fever are no different from those of any strep throat. In case of penicillin allergy, clindamycin or erythromycin can be used with success.

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  • ?
    Lv 7
    1 decade ago

    Scarlet fever is an illness caused by bacteria (germs) that usually just causes an infection of the throat ('strep' throat). Toxins (poisons) that are sometimes released by the bacteria may cause scarlet fever and also may cause damage to other parts of the body.

    The infection is spread by droplets of infected saliva from the mouth when the person sneezes and coughs, and from a runny nose .

    A streptococcal infection takes from 1-3 days to develop after contact with someone who has it.

    An untreated person is infectious for two to three weeks after becoming unwell.

    A person is infectious for about a day after antibiotic treatment is started.

    Scarlet fever- signs and symptoms

    Scarlet fever is a rare reaction to a streptococcal infection.

    The person suddenly becomes ill with a high temperature, sore throat, swollen tonsils and neck glands, lack of appetite, vomiting and a general feeling of being unwell.

    Within 12 to 48 hours a fine red, raised rash appears on the neck, chest, under the arms, in the elbows and groin and the inside of the thighs.

    The rash looks like sunburn and feels like rough sandpaper.

    The face may look flushed with a pale ring around the mouth.

    The rash lasts for about 2 to 5 days.

    Often the skin peels after the rash fades.

    Often the tongue looks redder than usual and the lumps on the tongue are larger than usual (something like a strawberry), often called 'strawberry tongue'.

    What you can do

    Any child with the signs of scarlet fever should be seen by a doctor straight away.

    People with scarlet fever need to treated with antibiotics to prevent complications.

    Paracetamol or ibuprofen may be given for the high temperature and sore throat (see the topic 'Using paracetamol or ibuprofen').

    Give lots of drinks.

    Control of spread

    The person with the infection needs to be kept away from others (isolated) until 24 hours after antibiotics are started.

    Children should cover their nose and mouth when they cough or sneeze if they have a sore throat or runny nose.

    Good hand washing needs to be done all the time, as infections can spread before people are aware that they are infected.

    People with sore throats should not prepare food for others.

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