Scarlet fever
"The use of penicillin in infected patients can sometimes prevent the development of the disease".
DR. JOSÉ RAMÓN YUSTE ARA
SPECIALIST. INFECTIOUS DISEASES SERVICE
What is scarlet fever?
Scarlet fever is an acute infectious-contagious disease of childhood, the symptoms of which are fever, pharyngotonsillitis and a characteristic rash with subsequent desquamation.
It is transmitted from a sick person to a healthy person through the air by droplets of saliva (Pflügge droplets) and nasal secretions. Carriers can also transmit the disease through objects or food (although less frequently).
The prognosis is good with appropriate treatment. In some cases it can be severe: toxic and septic forms.
Symptoms of scarlet fever
The most common symptoms are: High fever, sore throat, scarlet red rash, vomiting and headache.
- Incubation period: lasts 3-5 days and is asymptomatic.
- Invasion period (12-24 hours): sudden onset of high fever with peak at 2-3 days and painful pharyngotonsillitis. May be accompanied by other symptoms such as vomiting and headache, painful pharyngotonsillitis, enanthema (red stippling) on soft palate and very saburral tongue (covered with a whitish coating, but with red dots and red edges).
- Exanthematous or status rash period: lasts approximately 3-4 days. It starts with a sudden scarlet-red, diffuse, micropapular rash that is rough to the touch ("goose bumps"). It is more intense in the skin folds (Pastia's sign). The tongue is scaly and red with prominent papillae, giving it a raspberry appearance (typical of scarlet fever). There is also a diffuse reddening of both cheeks along the nasolabial fold ("Filatov's triangle").
- Period of desquamation or decline: may persist for weeks. Currently less frequent due to rapid response to treatment.
Do you have any of these symptoms?
If you suspect that you have any of the above symptoms,
you should consult a medical specialist for a diagnosis.
What are the causes of scarlet fever?
It is caused by a bacterium, group A haemolytic streptococcus, through its erythrogenic toxins A, B, and C. Scarlet fever leaves lasting immunity to the toxin, but the child may be infected by other types or strains of streptococcus.What are the complications of scarlet fever?
Complications can be:
- Precocious: they appear almost at the same time as the disease, such as otitis media, mastoiditis, cervical adenitis, laryngitis, bronchopneumonias....
- Late: glomerulonephritis, rheumatic fever, osteomyelitis...
How is scarlet fever diagnosed?
The diagnosis of scarlet fever is based on clinical symptoms and is confirmed by analytical tests, mainly the streptococcal rapid diagnostic test (RDT).
Other alternatives are the presence of streptococcus in culture of pharyngeal exudate or the measurement of anti-streptolysins in serum (antibody development), although their detection may not become evident until 2-3 weeks after infection.
The course can be very diverse and clinical forms can range from malignant (toxic, septic) to benign (latent, frustrated). The disease leaves long-lasting immunity to the toxin.
How is scarlet fever treated?
- Plenty of fluids.
- Rest during the febrile period.
- Analgesics and antipyretics.
- Antibiotics: penicillin V orally is the initial antibiotic of choice except in allergic individuals in whom azithromycin or clindamycin will be used. The duration of treatment should be 10 days, otherwise the germ may not be eradicated and the subject may become a carrier.
This is a school exclusion infection (until resolution of fever and at least 1 day of antibiotic treatment). Measures to prevent transmission include: proper hand hygiene of the child and caregivers, not sharing personal items such as eating utensils and towels.
Where do we treat it?
IN NAVARRE AND MADRID
The Infectious Diseases Service
of the Clínica Universidad de Navarra
This area works on the diagnosis and treatment of diseases produced by an infectious agent, which can be bacteria, virus, fungus and protozoa. Infections affect people by causing very different processes that can be located in any tissue of the human body, so it requires a specific approach.
This area carries out its activity on three fronts: care work, focused on the diagnosis and treatment of infectious diseases; teaching, with training of medical students, resident doctors and nurses; and research vocation, through the development of clinical and laboratory studies.
Organized in care units
- Infections associated with biomaterials.
- Nosocomial infections (multi-resistance).
- Infections in immunosuppressed patients.
- Community infection.
- Traveler's medicine.
- Prudent use and optimization program of anti-infective therapy.
- Control of infection by multi-resistant microorganisms.
Why at the Clinica?
- We perform the traveler's assessment and analytical tests in less than 24 hours.
- Second opinion consultation when the infection has not yet been resolved.
- We ensure the prudent use of antibiotics.
Our scarlet fever expert team
