The text is presented for informational purposes only. We urge you not to self-medicate. When the first symptoms appear, consult a doctor. Recommended reading: " Why not self-medicate?". Scarlet fever is an acute childhood infection accompanied by intoxication syndrome, rash on the body, pharyngeal congestion, and crimson tongue symptom. Most often, pathology occurs in children aged 2 to 10 years, a disease is possible in adulthood with a parallel flow of a number of certain conditions.
The main etiological cause of infection is the penetration of pathogenic streptococci into the body, namely pyogenic streptococcus, which is a representative of serogroup A. Infection with scarlet fever occurs most often by airborne droplets, other ways of infection are much less common. However, the disease caused by streptococcus may not develop in the presence of immunity, a strong immune system. It is the weakening of the immune system that is an important condition for the disease of scarlet fever.
Thus, getting into the human body by airborne droplets, contact hospital and household, sexually or due to trauma to the skin, streptococcal bacteria against the background of a weakened body begin to infect it, provoking not only scarlet fever, but also other streptococcal infectious processes - tonsillitis, bronchitis, laryngitis, tracheitis, pharyngitis, meningitis, endocarditis. Among the factors that make the body of an adult or child more susceptible to the development of infections, hypothermia, vitamin deficiency, improper work and rest regimen, chronic infectious diseases ( tonsillitis, pneumonia, tuberculosis, diabetes), a sedentary lifestyle, susceptibility to stress, bad habits, drug abuse. In children under the age of 5-7 years, the immune system is not yet fully formed, which is the reason for the high likelihood of infectious processes.
After a person has been ill with scarlet fever, he develops immunity to scarlet fever. However, due to mutations in modern bacterial infections, it remains possible to get sick with scarlet fever a second time. That is why it is necessary to always remember the rules for the prevention of the disease and not neglect them.
Symptoms and manifestations
Typical scarlet fever
The typical form of scarlet fever refers to the classic course of the disease with characteristic symptoms, which includes rash, sore throat, crimson tongue, fever. By severity, typical scarlet fever is divided into mild, moderate and severe forms with toxic, septic and toxic-septic signs.
Typical scarlet fever can also occur both without toxic-allergic reactions, and with them in the form of synovitis, nephritis, reactive lymphadenitis. Pathology may include toxic-allergic processes, be complicated by purulent processes and septicopyemia, and be abortive.
Atypical form and its main manifestations
Under atypical forms or erased forms of scarlet fever are those pathologies that occur without the characteristic signs characteristic of this disease. Erased forms most often occur in adult patients, they are characterized by a mild and rapid course, without a long clinic. In this case, a rash, if it occurs, is for a short time, the patients' throats turn slightly red, sometimes patients notice slight nausea and low-grade body temperature. Erased forms may sometimes have hypertoxic or hemorrhagic aggravated symptoms.
However, in the toxic-septic form of atypical scarlet fever, the symptoms can be very severe. This is a rare phenomenon in medicine that occurs in adult patients with scarlet fever, and is accompanied by rapid development with a very high body temperature, the development of cardiovascular insufficiency in the form of muffled heart sounds, thready pulse, a sharp decrease in blood pressure, hemorrhages on the skin. Over the next day, infectious and allergic complications can join these symptoms - damage to the heart, kidneys or joints, as well as septic complications in the form of otitis media, necrotic tonsillitis, lymphadenitis and others.
There is also the concept of extrabuccal scarlet fever, when the disease proceeds without a special clinic and manifests itself only in a rash at the site of violation of the integrity of the skin from a cut or burn, where the infection could penetrate.
Stages of development of infection
The incubation period for scarlet fever lasts from 24 hours to 10-12 days. At the moment a streptococcal infection enters the body, clinical signs do not immediately appear, but a person may already be contagious to others. After the disappearance of clinical symptoms for several days, the patient can also still remain contagious, but the most dangerous for those around the patient with scarlet fever is in the first days of active symptoms.
If we talk about the most common picture of the disease, then the incubation period for scarlet fever occurs 2 days after infection and lasts 7 days.
The beginning of the development of the disease
At the initial stage of the disease, the patient is the most contagious to others. At this time, the main symptoms of the pathology develop and their clinical picture is actively progressing. The body temperature at this moment can rise sharply to 40 degrees, the function of swallowing is very difficult, the patient may feel sick, the rash on his body appears only 12 hours after the development of the disease, and until that time it is actively progressing on the mucous membrane of the throat. The initial stage of scarlet fever usually lasts 24 hours.
Stage of active disease
This stage is a severe period of scarlet fever and lasts up to 5 days, when symptoms are very actively expressed - tonsillitis, profuse punctate rash all over the body, beyond with the exception of the nasolabial triangle, various manifestations of intoxication, which are caused by the processes of reproduction of streptococcal infection in the patient's body.
The patient's throat is very painful, bright red (flaming throat), so many patients, and especially children, completely refuse to eat at this time.
The papillae clearly appear on the tongue, it itself turns crimson.
It is during the height of the disease that various complications can join - sinusitis, pharyngitis, purulent lesions of the liver and kidneys, cardiovascular pathologies. As soon as the symptoms become less pronounced, we can say that scarlet fever has passed into the recovery stage.
In the recovery stage, all symptoms of the disease completely disappear. This period can last from 7 to 22 days. At this time, the patient's body temperature normalizes, the sore throat disappears, the rash disappears, at the site of which peeling occurs due to the influence of erythrotoxin. The skin flakes very strongly, it can start to peel off, especially in the area of the limbs, auricles, armpits. In children, a characteristic symptom that the patient has been ill with scarlet fever is peeling of the skin on the hands in the form of a glove. Finally, the skin stops peeling only by the end of the third week after the symptoms disappear.
The stage of recovery of scarlet fever in the absence of the necessary treatment of the disease with the use of antibiotics can be complicated by rheumatism, vascular inflammation, since streptococci have a highly allergenic factor that negatively affects the internal organs of a person. It is also possible the occurrence of long-term complications in the form of an inflammatory process in the kidneys (glomerulonephritis), heart muscle (myocardial inflammation), heart valves (endocardial inflammation), brain (Sydenham's chorea), joints.
Scarlet fever grades
In today's world, scarlet fever is most often mild. This is due to the use of antibacterial drugs for treatment in the early stages and the improvement in the quality of life of people, expressed in stable nutrition and increased protective functions.
Mild scarlet fever with moderate symptoms. Body temperature usually rises no more than to the level of 38.5 degrees, nausea, vomiting, headaches are either absent at all, or they are expressed in a very weak form, catarrhal manifestations such as tonsillitis and pharyngitis occur without pustular plaque on tonsils. Only the hypertrophy of the lingual papillae and its bright crimson hue are preserved in a mild form of pathology.
Skin rash in this form of the disease is either completely absent, or manifested by a small number of soft rashes. After the rash comes peeling of the skin, which, due to the low aggressiveness of the inflammatory elements, is also poorly expressed.
Acute symptoms of mild scarlet fever resolve within 5 days. After 3 days, intoxication, fever disappear, then the rash and tonsillitis begin to disappear. Only the tongue acquires a healthy appearance after 10 days. At the same time, there are no late complications in an infection of this form.
Moderate form of scarlet fever is characterized by an increase in temperature to 39-40 degrees, the onset of general weakness, feeling of nausea and headaches. Sometimes high temperature provokes hallucinations and delirium. Increased intoxication of the body can cause repeated vomiting. The patient's heart rate increases, symptoms of "scarlet fever" may occur - shortness of breath, pain behind the sternum. Symptoms of sore throat are supplemented by purulent plaque in the throat, skin rashes are very pronounced, and peeling after them at the stage of recovery delivers a lot of discomfort.
Primary symptoms of moderate scarlet fever disappear only after 5-7 days of illness. During this period, body temperature also stabilizes. With this form of pathology, the development of early complications of scarlet fever associated with the spread of the pathogen in organs and tissues is possible.
Late complications in this case also sometimes occur. They can be expressed in myocarditis, nephritis, articular rheumatism. In order to avoid their development after the main symptoms of the disease have passed, it is recommended to take blood and urine tests, and undergo an ECG.
Moderate scarlet fever in children often needs to be treated in a hospital setting. If the pediatriciantreating the child insists on hospitalization, this should by no means be resisted, since the risk of complications can be extremely high.
Due to the timely administration of antibiotics, severe forms of scarlet fever are rare today. In this case, hyperthermia of the body can reach 41 degrees and cause mental disorders, delusions and hallucinations. Intoxication processes can also be pronounced - the patient may constantly feel sick, he will experience an increase in heart rate and a severe headache. Regarding the manifestations of angina, it is worth noting that, in a severe form of pathology, it can affect, in addition to the pharynx, the entire oral cavity, palate, and middle ear. The rash in this case is pronounced and plentiful.
A severe form of scarlet fever can occur in several forms. Toxic scarlet fever is caused by exposure to an erythrotoxin released by streptococci during reproduction. The result of this type of disease is a pronounced poisoning of the body, intoxication up to the development of intoxication-toxic shock, high body temperature.
In the septic variety of the severe form of scarlet fever, an extensive purulent-necrotic lesion of the nasopharynx develops along with adjacent tissues. The toxic-septic form of the disease is considered the most dangerous, since it combines the symptoms of the two types of pathology described above with a severe course and can pose a threat to the patient's life. If there are signs of a severe form of scarlet fever in patients of any age, urgent hospitalization and therapy under medical supervision are necessary.
Complications and consequences of scarlet fever
The development of complications in scarlet fever in children does not depend on the sex of the child. Dependence in this case can be observed only based on the age of the patient. In younger patients, the risk of complications is much higher.
Scarlet fever was previously thought to cause future infertility in boys who had it, but to date, there is no evidence-based relationship between male infertility and this infection.
The following concomitant factors can lead to complications in scarlet fever in boys and girls:
- recent acute respiratory infections;
- infection due to another chronic disease;
- incorrect and untimely therapy of the disease;
- decrease in the protective immune forces of the patient's body.
All complications of scarlet fever are usually divided into early and late. Among the early complications are otitis with inflammatory purulent processes in the middle ear, pharyngitis, characterized by redness of the posterior pharyngeal wall, sinusitis with purulent inflammation in any nasal sinus, lowering blood pressure, bradycardia, paratonsillar abscesses.
The impetus for the occurrence of late complications of scarlet fever is toxic-allergic reactions to the streptococcal pathogen. Among them, inflammatory processes in the heart valves are especially common, which can only be treated surgically, articular inflammation - synovitis with swelling of the joints, severe pain during their movements, brain damage with severe uncontrolled motor activity or glomerular renal apparatus, which subsequently leads to chronic kidney failure. Late complications are very severe, they lead to persistent violations of the functionality of vital organs.
In adult patients
Most often, scarlet fever in an adult is mild, which does not depend on how many times the patient suffers from the disease. In rare cases, without the use of adequate therapy, the disease can become extremely severe. Symptoms of the disease in adulthood do not differ by gender.
Among the main symptoms of scarlet fever in adults, doctors distinguish:
- acute tonsillitis;
- hyperthermia and intoxication;
- rashes followed by peeling of the skin.
The main early complications of scarlet fever in adults are changes in cardiac and vascular work, the spread of infection to the liver and kidneys, and the nasopharynx. Among the late complications, doctors distinguish articular rheumatism, inflammation of the heart muscle, and pathological renal lesions.
Among the most common complications of this infection are:
- purulent lymphadenitis;
- purulent otitis media;
- severe allergic reactions;
The negative impact of scarlet fever on the reproductive system of men is not supported by scientific data. Streptococcal infection does not leave an imprint on the genitourinary system, and therefore cannot lead to testicular atrophy. However, while a man is being treated for scarlet fever, conception of a child should be postponed until antibiotic therapy stops.
Complications during pregnancy
Scarlet fever is a great danger in the first trimester of pregnancy, since during this period all the organs and systems of the unborn child are laid, and the treatment of pathology requires urgent medication. Sometimes the use of antibiotics for scarlet fever in pregnant women leads to a forced abortion.
In the second and third trimesters of pregnancy, scarlet fever is not able to affect the embryo so much, since the formed placenta has protective functions and prevents drugs and infections from entering the baby's body. However, sometimes intrauterine hypoxia, pathological course of labor, or even premature birth can occur as a complication of scarlet fever in pregnant women.
Diagnosis of the disease
What tests to take
Despite the abundance of obvious external manifestations of scarlet fever, in rare cases Some lab results will be needed. If scarlet fever is suspected in a patient, the doctor sends him to a general blood test, according to the results of which it will be possible to see changes characteristic of a bacterial infection - an increase in leukocytes and ESR. It is also often necessary to carry out bacteriological culture from the nasopharynx and pharynx to determine the sensitivity of microorganisms to a particular antibiotic and to identify streptococcus. An additional throat swab helps identify streptococcal antigens. Also, the result of a blood test for antistreptolysin-O can indicate the presence of a streptococcal infection. Conducting all of the above laboratory tests helps to detect the presence of an infection even before the first symptoms develop.
As already noted, scarlet fever is often diagnosed during a routine medical examination, because it has a specific symptomatology. Information about contacts with infected patients and about the transfer of pathology in childhood will help to confirm the assumption. However, the presence of some related symptoms with measles, rubella, pseudotuberculosis and diphtheria requires differential diagnosis.
A specific symptom of scarlet fever is a flaming pharynx with a clear restriction of the transition of the mucous membrane to the hard palate. Also, only with this infection, changes in the tongue appear - it becomes bright crimson in color, and the papillae on its surface are significantly hypertrophied. The rash in scarlet fever is punctate, it usually thickens at the articular folds. The only place on the patient's body that is clean from rashes is the pale nasolabial triangle. When pressing on the skin with a rash, the latter then disappears for a while. When the rash completely disappears, the patient's skin is very flaky, while in the area of \u200b\u200bthe feet and palms it can come off in huge layers.
The moment of development of all the main symptoms of scarlet fever is always accompanied by hyperthermia, which can vary from 38.5 degrees in a mild form of the disease to 41 degrees in a severe form.
Methods of treatment
Medical products (preparations, medicines, vitamins, medicines) are mentioned for informational purposes only. We do not recommend using them without a doctor's prescription. Recommended reading: " Why can't you take medications without a doctor's prescription?". Mild and moderate forms of the infection in question are treated at home, and only severe cases require inpatient treatment. For the treatment of scarlet fever, antibiotics (moderate and severe forms of infection), antihistamines are necessarily used to neutralize erythrotoxin, which has a powerful allergenic effect on the human body. If the body temperature during the disease is very high, then it is advisable to use antipyretic drugs. To relieve sore throat, local antiseptics are used in the form of sprays, rinses, lozenges. To eliminate severe intoxication, the patient may be prescribed intravenous detoxification drugs.
However, in addition to symptomatic treatment and antibiotic therapy for scarlet fever, it is very important to use medications to increase the body's defenses. For this purpose, doctors prescribe to patients vitamins of groups B and C, multivitamin and immunomodulatory complexes.
Also, in addition to drug therapy, the system of scarlet fever treatment necessarily includes adherence to bed rest, a special diet with a high content of vitamins in food, and plenty of fluids.
To prevent infection of other family members from a patient with scarlet fever, it is important to regularly ventilate the room, carry out frequent wet cleaning using various disinfectants, and boil the bed linen of the patient and his dishes. 2 weeks after the patient's recovery, it is important for him to conduct a routine examination in order to avoid the development of late complications.
Is it possible to get sick again
Medical workers know cases of scarlet fever twice and even three times during a lifetime. The weakened immune system of the patient, together with a number of provoking factors, is to blame for this pathology. These factors include untimely treatment of scarlet fever that has arisen, which is started too forcefully in childhood, which can lead to a stop in the mechanisms of formation of immunity against infection in the future. With early antibiotic therapy, the antibodies produced in the body can be completely leveled by drugs, which will lead in the future to a lack of immunity and the possibility of re-infection.
A second risk factor for relapse may be early infection. It is known that the child's own immunity arises in the body only by the age of 2, which means that he will be able to re-infect with all the infections that he had before. However, there are few precedents in medical practice regarding the infection of such young children, since infants are usually protected by maternal antibodies from breast milk.
Another factor that provokes re-infection with scarlet fever can be simultaneous infection with several types of infection, which is also quite rare. At the same time, if rubella and scarlet fever viruses enter the body at the same time, then the immune response occurs only in relation to the main, stronger of them, and the second disease may develop again in the future.
Bacterial infections in modern conditions tend to develop resistance, therefore, cases of re-infection with any infections to which a strong immunity should be formed in the human body are not ruled out, therefore it is recommended not to neglect the methods of preventing such diseases.
Prevention of the disease
Scarlet fever can be prevented only by observing hygiene rules when caring for the sick and timely quarantine in relation to the infected. There is no vaccination against scarlet fever in medicine, therefore, only in such ways it is possible to carry out the prevention of the disease.
If a sick person with scarlet fever is detected in the children's group, then a seven-day quarantine is established here. After the child has come into contact with the carrier of this infection, he can be sent to the team only after 17-22 days. If the child had scarlet fever at home, he can start visiting the team only 22 days after the onset of the disease, and for those who were treated for infection in the hospital, only 12 days after discharge from the hospital.
Prevention of scarlet fever necessarily implies certain hygiene rules. When returning home from crowded places, wash your hands thoroughly with soap and water. If a person is in a public place, try to stay away from those who have symptoms of a cold ( cough, sneezing, runny nose ). In a house where there is a child with scarlet fever, all surfaces and toys are regularly washed with a solution of chloramine, and dishes and bedding are boiled.
Adults in contact with the patient are advised not to neglect the rinsing of the throat with antiseptics, especially in the case of chronic pathologies of the upper respiratory tract in anamnesis.
To stop the spread of infection, patients need to be isolated from others. However, such isolation will be effective if it is started from the first hours of the onset of symptoms, since the disease is contagious from the onset of infection. Patients with severe forms of pathology can be isolated in a hospital, if the family of the sick person has children under the age of 10 who have not recovered, those patients who have healthy relatives in the family who work in preschool and junior school institutions, as well as in hospitals.
If scarlet fever is detected in children's institutions, groups are quarantined for a week from the moment the last infected person is isolated. Isolated healthy members of such a team are examined by a doctor twice a day. If they have even banal symptoms of SARS, they are also isolated from the rest of the team, and the quarantine is extended for another 7 days.
The text is for reference only. We urge you not to use diets, do not resort to any medical menus and fasting without medical supervision. Recommended reading: " Why you can't go on a diet on your own". In the case of scarlet fever, dietary nutrition is an important part of the overall treatment. At the same time, fatty and fried, spicy and smoked foods should not be abused, since the body is already weakened from infection. From the diet it is required to exclude soda, coffee, chocolate, as well as other products that irritate the throat mucosa.
It is necessary to eat light soups and broths, liquid cereals, fresh fruits and vegetables, providing the body with the necessary vitamins and microelements. In general, in the case of scarlet fever, doctors most often recommend a dietary menu according to established rations "Table No. 2" or "Table No. 13" in the early stages of the disease, and "Table No. 7” after 14 days from the onset of the disease. The most useful is a fractional meal up to 7 times a day with steamed dishes. Among the most useful products from which the diet of a patient with scarlet fever should be composed are radish, cabbage, pumpkin, beets with their anti-inflammatory effects, berries, fruits, tea with lemon, blackcurrant to cleanse the body of toxins and toxins and increase its protective functions, rosehip broth, juices and compotes to eliminate the symptoms of dehydration of the body, steam dishes from fish and meat, fermented milk products that prevent the occurrence of dysbacteriosis when taking antibiotics, honey, fish oil and so on.
Contraindications for scarlet fever
When suffering from scarlet fever, the patient must observe bed rest, as it helps to accumulate the body's strength for a speedy recovery. In this way, the isolation of the sick person from society also occurs. At the same time, bed rest during infection is required from 8 to 10 days. It is necessary to ventilate the room where the patient is located several times a day.
Walking with a child in case of his illness with scarlet fever is allowed only if his state of health returns to normal, and he himself does not oppose such walks. An important factor for the possibility of walking is the presence of antibiotic therapy in the treatment regimen. At the same time, the first walk can be carried out only a day after the first intake of an antibacterial drug, since only after such an amount of time the sick child ceases to be infectious for others. In the absence of antibiotic therapy in the treatment regimen, walking with a sick child is possible only after 10 days from the moment the infection develops.
But, even observing the above rules, walking with a sick child is possible only where there are no people at all, since the patient must be protected from an external meeting with the very minimum concentration of streptococcus, which can cause severe complications in scarlet fever. And since every person is a carrier of streptococcus (certain types of such bacteria make up the microflora of the human body), it is necessary to completely exclude any contact until the quarantine is completely lifted.
Since scarlet fever is an infectious process, it is better to avoid bathing in the first days of illness to prevent complications.
Hygiene procedures can be started from the time when the body temperature is completely normal. At the same time, one should carefully monitor the temperature of the water (it should not be either hot or cold), do not use washcloths and do not rub the skin. After bathing, the body should not be dried, it is recommended to lightly blot the skin to remove moisture.
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