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Scarlet Fever: Symptoms, Causes, Diagnosis, Complications And Treatment

Scarlet fever or scarlatina is an illness that occurs as a result of group A streptococcus I infection, alternatively known as Streptococcus pyogenes. It mainly affects children between the ages of 5 to 15 and if left untreated, it can lead to severe complications. However, around 80% of cases arise in children under 10 years. A small number of people with streptococcal pharyngitis infection (also known as strep throat) or streptococcal skin infections, develop scarlet fever sometimes.

Scarlet fever had caused several child-deaths in the early 20th century. Nevertheless, the invention of modern antibiotics has made it a lot less threatening and much rarer. Timely diagnosis and treatment can soothe the symptoms in no time. Continue reading to find out about the associated symptoms, causes, diagnosis, treatments and prevention of this condition.

Symptoms Of Scarlet Fever

This condition is mostly associated with scarlet-coloured rashes. They begin as red blotchy rashes and turn into a rough and sand-paper like surface. These characteristic rashes are called as "scarlatiniform" and they resemble goose pimples [1] . The primary symptoms appear about 1 to 4 days after the initial infection. Rashes show up from 12 to 48 hours of the onset of the symptoms.

Signs and symptoms are a mix of the following:

  • A red, sore throat with white or yellow patches
  • Fever above 101ºF (38.3ºC)
  • 'Strawberry tongue' with a white coating and red dots on the surface
  • Chills
  • Headache
  • Swollen neck glands or lymph nodes
  • Abdominal pain
  • Nausea and vomiting
  • Loss of appetite
  • Swollen tonsils
  • Broken blood vessels in the armpits, elbows, groins and knees (known as Pastia's lines) [2]

Causes Of Scarlet Fever

The Streptococcus pyogenes bacteria, responsible for scarlet fever, usually spread through infected saliva, nasal secretions, sneeze or cough. At times, touching the mouth or nose after coming in touch with an object that has bacteria on it, might contribute to its transmission. [3] .

Drinking from the same glass or eating from the same utensils with the infected person, may increase your risk of being infected. The toxin, produced by this bacteria causes red rashes. So touching the rash does not spread the bacteria, as the rash is a result of the toxin, not the bacteria itself [4] .

Diagnosis Of Scarlet Fever

Diagnosis includes a physical examination and throat swab. Doctors perform a physical examination to check for conditions of your child's throat, tongue and tonsils, the appearance of the rash and lymph nodes.

In the second step, the doctor will do a throat swab, where a sample of throat cells is collected by swabbing the back of your child's throat. The sample, afterwards is sent for analysis to determine if group A streptococcus is present [5] .

Complications Of Scarlet Fever

Most cases of scarlet fever do not turn out to be severely complicated. However, some of the complications caused by this disease include

  • rheumatic fever,
  • inflammation of the kidneys,
  • ear infections,
  • skin infections,
  • pneumonia,
  • sinusitis,
  • arthritis, and
  • throat abscess.

Treatment Of Scarlet Fever

Though mild cases of this fever resolve themselves within a week without treatment, doctors mostly prescribe a course of oral antibiotics. You need to ensure that your child completes the course of prescribed antibiotics. This will prevent the infection from recurring in future.

Penicillin is the most commonly used antibiotic for scarlet fever [6] . However, patients allergic to penicillin, are advised to take erythromycin or another antibiotic [7] . If the symptoms do not begin to alleviate within 24 to 48 hours after starting the antibiotic treatment, you should consult a physician again.

Prevention

So far, there are no vaccines available for scarlet fever. However, maintaining good hygiene is the key to prevent scarlet fever. Here are a few preventive measures that your kids should follow:

  • Make sure they wash their hands before eating and after using the restroom.
  • Teach your children to cover their mouth while sneezing or coughing, as well as wash their hands afterwards.
  • It is always safe not to share their drinking glasses with others in school.

How To Take Care Of Your Child During Scarlet Fever

Apart from proper medication, here is a run-down of some home remedies that can help soothe the discomfort related to scarlet fever.

  • It is important to drink plenty of water to keep dehydration at bay.
  • Eating warm and broth-based soups, drinking warm teas, gargling with salt water and using a cool air humidifier can ease throat pain.
  • Give your child soft food or preferably liquid diet.
  • For children over 4 years, throat lozenges can be beneficial.
  • Keep them away from polluted air.
View Article References
  1. [1] Miller, R. A., Brancato, F., & Holmes, K. K. (1986). Corynebacterium hemolyticum as a cause of pharyngitis and scarlatiniform rash in young adults. Annals of internal medicine, 105(6), 867-872.
  2. [2] Dick, G. F., & Dick, G. H. (1924). The etiology of scarlet fever. Journal of the American Medical Association, 82(4), 301-302.
  3. [3] Aranow, H., & Wood, W. B. (1942). Staphylococcic infection simulating scarlet fever. Journal of the American Medical Association, 119(18), 1491-1495.
  4. [4] Johnson, L. P., James, J. L., & Schlievert, P. M. (1986). Streptococcal pyrogenic exotoxin type A (scarlet fever toxin) is related to Staphylococcus aureus enterotoxin B. Molecular and General Genetics MGG, 203(2), 354-356.
  5. [5] Perks, E. M., & Mayon-White, R. T. (1983). The incidence of scarlet fever. Epidemiology & Infection, 91(2), 203-209.
  6. [6] Weinstein, L., & Clifford, C. L. T. (1946). Effect of Types of Treatment on Development of Antistreptolysin in Patients with Scarlet Fever. Proceedings of the Society for Experimental Biology and Medicine, 63(2), 449–450.
  7. [7] Haight, T. H. (1954). Erythromycin therapy of respiratory infections. I. Controlled studies on the comparative efficacy of erythromycin and penicillin in scarlet fever. Journal of Laboratory and Clinical Medicine, 43(1), 15-30.

Read more about: fever disease
Story first published: Monday, August 5, 2019, 12:30 [IST]
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