Recurrence of scarlet fever

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Scarlet fever (Relapses)

Relapses of scarlet fever usually occur during the week of illness, but can also develop earlier - on the 2nd week (day). In these cases, it is very important that the initial diagnosis of scarlet fever does not raise any doubts, since by this time scarlet fever may occur in children mistakenly placed in the scarlet fever department.

Table of contents:

Recurrences of scarlet fever are in most cases associated with reinfection and superinfection with new variant hemolytic streptococcus. This situation is confirmed by the higher frequency of relapses in children in a general ward, where contact between recovering patients and newly admitted patients is not excluded.

Outcomes. Currently, scarlet fever is a mild disease, usually with a favorable outcome. In patients with chronic tonsillitis and in children with rheumatism, during the period of convalescence of scarlet fever, prolonged low-grade fever, various complications, and there may also be an exacerbation of the rheumatic process.

Scarlet fever is currently distinguished by a number of features: the presence of predominantly mild forms of the disease, the absence of purulent complications, rapid sanitation of the body from hemolytic streptococcus, which is achieved by the early use of penicillin and the creation of the correct conditions for hospitalization, excluding reinfection (simultaneous filling of the wards with patients).

“Infectious diseases in children”, N.I. Nisevich

Drug rash in a child suffering from exudative diathesis: Diagnosis and differential diagnosis. Recognizing scarlet fever in typical cases is not difficult. Difficulties arise when patients arrive late, when the rash has already faded. The diagnosis is facilitated by the “saturation” of skin folds, which lasts longer than the rash on other areas of the skin, the presence of petechiae on the neck, in the armpits, and a “crimson tongue.” It should also...

Exudative diathesis, erythymatous-papular rashes: In cases of staphylococcal infection, the rash usually appears in the presence of some purulent focus (purulent lymphadenitis, osteomyelitis, etc.). There may be no “saturation” of skin folds, there may be no sore throat, and the “crimson tongue” characteristic of scarlet fever does not always occur. Differential diagnosis between scarlet fever and pseudo-tuberculosis does not present great difficulties at present. Rash…

Treatment of patients with a mild form of scarlet fever under appropriate conditions (the ability to isolate the patient in a separate room) is carried out at home. Scarlet fever departments should consist of human wards. These wards are filled with patients simultaneously throughout the day. Patients in one ward should not have contact with patients in another ward. This eliminates the possibility...

Prevention. Specific prevention of scarlet fever has not been developed. General preventive measures boil down to early detection and isolation of the source of scarlet fever. Children with scarlet fever are hospitalized in a hospital or isolated at home for a period of 10 days from the moment of illness. The child can be sent to a child care facility 22 days after the onset of the disease. In children's institutions, outbreaks of scarlet fever are also isolated...

Erysipelas is one of the forms of streptococcal infection, characterized by damage to the lymphatic and circulatory system of the skin, and less commonly, the mucous membranes. Erysipelas can be caused by any serovar β - hemolytic streptococcus from group A. The source of infection is a patient with streptococcal infection or a streptococcal carrier. There is selective susceptibility or predisposition to erysipelas; Some people get erysipelas many times. Immunity does not develop after erysipelas...

The information on the site is for informational purposes only and is not a guide for self-medication.

Source: http://www.medkursor.ru/deti/infection/ctrept/409.html

What are the complications after scarlet fever in children?

It is better to know in advance that complications after scarlet fever in children can occur regardless of how the disease progressed, so as not to lose vigilance and immediately consult a doctor at the first signs of their occurrence. Complications can affect different organs and occur in a more or less severe form, but in any case they are extremely dangerous for the child’s health.

Occurrence of complications

Scarlet fever is considered a rather dangerous disease precisely because of the possibility of symptoms appearing after recovery. Although the form of scarlet fever does not affect the occurrence of complications, there are a number of factors that can make the risk of their occurrence minimal:

  • compliance with doctor's recommendations and regimen;
  • placing the patient in the hospital at the initial stage of the disease;
  • prescribing a course of antibiotics;
  • strengthening the child's immunity.

Thanks to the development of medicine, fewer and fewer children are suffering from complications of a purulent nature. In order to prevent serious consequences, it is necessary to take into account the fact that they sometimes occur even after the child’s temperature has become absolutely normal. In addition, the first manifestations of complications (rash, sore throat) can be quite invisible, which is why, at the slightest suspicion, you should seek help from your doctor.

Complications can appear either immediately after the illness or after some time; on this basis they are divided into early and late. Sometimes a relapse of the disease can be confused with symptoms of late complications, so it is up to the doctor to make the diagnosis.

In order to determine the occurrence of complications as quickly as possible, you should become familiar with the most common of them, which appear during different periods of recovery.

Complications arising in the early period

As a rule, this type of complications occurs due to the spread of infection, which can manifest itself in different ways and affect the hearing organs, nasopharynx and even internal organs. The youngest children are more susceptible to such processes, since the protective functions of their body are the most vulnerable. The infection can be caused by streptococcus or staphylococcus. If the nasopharynx is affected, then the accumulation of pus near the tonsils can significantly aggravate the patient’s condition. Other aggravating factors are laryngitis, pharyngitis and sinusitis. Rarely, more severe cases of inflammation occur when the liver and kidneys are affected.

Due to damage to the child’s body by toxic substances, the heart and kidneys may be damaged, and disturbances in their functioning may appear. 1-2 weeks after the illness, there is a chance that the child will develop “toxic heart” - a process meaning complications with the heart muscle after scarlet fever, which may increase in size. The child may experience a significant drop in blood pressure, a slow pulse, and anxiety. In addition, pain in the sternum and difficulty breathing are indicators of the occurrence of this process.

2-3 weeks after the illness, the child may be susceptible to allergic waves, which are accompanied by high fever. It happens that rashes reappear, which are externally different from those that appear with scarlet fever, but the places of their occurrence are usually similar. The rash may disappear, but this does not indicate the disappearance of complications, because repeated eruptions of the rash are common, alternating with its complete disappearance.

Allergic complications after scarlet fever have symptoms similar to a normal allergic reaction, such as nasal congestion, swelling of the face, tears, cough, sore throat. The child’s lymph nodes usually enlarge during an allergic wave, the heart beats faster, although the pressure may be low. This allergy affects the child’s kidneys and cardiovascular system, which can lead to hemorrhages, including in the brain. Such a risk should force parents to be very attentive to the condition of their child after he has had scarlet fever.

Complications that occur at a later stage

This type of complications is, as a rule, a consequence of an allergic reaction on the child’s body, which often occurs due to the appearance of streptococci, making the body more susceptible to environmental conditions. Rheumatism of the joints is considered one of the possible late complications that occurs a couple of weeks after suffering from a sore throat. The child may feel quite severe joint pain, accompanied by redness of the skin in the area above the sore spot. It is believed that such a complication does not lead to serious consequences.

Scarlet fever can affect the baby's heart valves, which is a very serious condition that requires surgery. If rheumatism has had an adverse effect on the valves, they may become tighter and even rupture. Blood circulation in the body is disrupted, causing the heart to suffer. Heart failure at an early age most often appears for this reason. Due to the seriousness of such consequences, it is necessary to carefully and regularly monitor a child with a doctor after a sore throat caused by streptococcus, especially if there is pain in the joints. If there is the slightest suspicion of damage to the heart valves, you should immediately consult a specialist, because the fact that the heart can work in this condition for some period does not reduce the risk of heart failure.

Scarlet fever can seriously damage the kidneys, so one of the serious complications is glomerulonephritis, which involves damage to the glomeruli of the kidneys. The presence of the disease may be indicated by the child’s poor health, high temperature, unpleasant or painful sensations in the lower back, the appearance of swelling and a decrease in the amount of urine produced. If you consult a specialist in a timely manner, you can avoid irreversible changes in the body and completely restore the child’s health, but in advanced cases, renal failure may develop, which leads to serious disruptions in the functioning of these organs.

Scarlet fever can affect the cerebellum area of ​​the brain - this is how Sydenham's chorea occurs. The first time after scarlet fever, the child may behave as usual and not feel any changes. After some time, he becomes more restless, absent-minded, often begins to forget something, insomnia, causeless laughter or crying appear. The first symptoms of such a serious complication may resemble the usual behavior of a capricious child and remain invisible to parents. Only at a late stage do noticeable signs of the disease appear - uncontrolled movement of the limbs. For the same reason, speech and gait may change.

The outcome of a brain disease is difficult to predict in advance, since it is possible to be completely cured of the disease or experience irreversible changes.

Recurrences of scarlet fever

If competent and timely treatment for scarlet fever is prescribed, the disease will rarely reoccur, but if the child’s immunity is too weakened and the body becomes a carrier of streptococcus, then relapses are likely. To exclude the occurrence of unpleasant complications from a relapse of the disease, you should be regularly observed by specialists, do all the necessary tests and follow the recommendations.

In most cases, a child who has had scarlet fever develops immunity to this disease, but if this does not happen, then contact with a carrier can lead to a relapse. It should be borne in mind that immunity to scarlet fever will not protect against sore throat, otitis media and other streptococcal diseases. If a child has chronic diseases of the nasopharynx, he may be susceptible to recurrent scarlet fever.

To protect your child from complications and the occurrence of recurrent scarlet fever, you must follow the doctor’s recommendations, strengthen your immune system in every possible way, follow a diet, undergo a preventive examination and, if suspicious symptoms occur, immediately go to the hospital.

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Source: http://moipediatr.ru/skarlatina/oslozhneniya-posle-skarlatiny-u-detej.html

Types of complications with scarlet fever

Scarlet fever is currently not as severe as it was typical for the disease at the beginning and middle of the last century. Despite this, streptococcus and its toxins can also cause certain complications, manifested by damage to internal organs.

Antibiotic therapy, symptomatic treatment and bed rest in the first days of illness minimize the risk of developing secondary diseases after an infection. Complications of rheumatism are caused by the impact on the body of three pathogenicity factors of streptococcus at once, these are toxic, infectious and allergic effects on organs and systems. As with all infectious diseases, the consequences of streptococcus in scarlet fever can be divided into early and late.

Scarlet fever - early complications

Early complications develop during the active phase of the disease and in the first days after the signs of the disease have subsided. The number of people who note the appearance of secondary diseases directly depends on the severity of the disease. Early complications are most often detected if the disease occurs with severe symptoms in septic and toxic-septic forms of scarlet fever. Late complications do not depend on the form of the disease and the severity of its clinical picture. That is, complications can be expected in the third or fourth week of illness, even if scarlet fever was quite mild.

The frequency of both late and early complications depends on the age of the sick person. Young children develop secondary pathologies much more often. In schoolchildren and adolescents, complications occur less frequently, but they can affect many body systems. Early complications include:

  • Otitis, that is, inflammation of the ear, develops in the first week of the disease, as well as after treatment. Otitis media can be purulent and, if not treated promptly, can lead to hearing loss.
  • Sinusitis is inflammation of the sinuses. Streptococcus penetrates through the ascending path from the mucous layers of the oropharynx into the sinuses, causing their inflammation. Sinusitis in most people after scarlet fever is one-sided.

In adults, the likelihood of developing early complications with scarlet fever increases with the toxic-septic form of the disease. Moreover, these negative consequences can be very serious. In addition to the typical consequences for children, purulent arthritis and diffuse myocarditis develop, which becomes protracted.

Late complications

Late consequences of scarlet fever usually include those that are detected already in the second or third week after the complete disappearance of symptoms. Often the diseases are protracted and severe, some of them can lead to disability.

  • Nephritis. Kidney damage also occurs in the early period, but, as a rule, these changes pass without consequences for health. Scarlet fever nephritis is detected approximately on the 20th day from the onset of the disease, sometimes kidney damage can occur a month later. This nephritis is defined as acute glomerulonephritis. The onset of the disease is acute, fever rises, swelling under the eyes and legs, fluid retention in the body, symptoms of intoxication. Acute glomerulonephritis requires immediate hospitalization in a hospital, where treatment is already being selected.
  • Articular rheumatism mainly develops two weeks after the onset of scarlet fever. The child complains of pain in large and small joints of the extremities, initially it is usually the arms. The skin over the joint is hot, hyperemic, and painful on palpation. Timely treatment allows you to survive streptococcal rheumatism without consequences.

Late complications of scarlet fever in most cases are caused by incorrect or untimely treatment. Also, the number of secondary diseases depends on the general resistance of the body and the state of the immune system.

Some people believe that scarlet fever is more dangerous for boys than for girls. There are no differences in the number of complications and their severity in boys compared to girls. The only thing that doctors note is a large number of glomerulonephritis in males. Another infectious disease that poses a danger to boys is mumps or mumps; if it is not treated correctly, it can damage the genitals and, as a result, infertility.

Prevention of complications

Most secondary diseases after scarlet fever or during it can be prevented if all measures are taken to prevent them. The likelihood of negative consequences is reduced by following the following stages of treatment:

  • During the acute period of the illness, the patient is prescribed bed rest. Rest reduces the likelihood of the spread of streptococcus during scarlet fever.
  • It is necessary to drink as much liquid as possible and it is advisable that it be fortified - tea with lemon, rosehip decoction. Sufficient drinking regimen allows you to quickly remove all toxins and cleanses the kidney tissue of the microorganism.

It is necessary to ventilate the patient's room

It is also necessary to protect those people who care for the patient from scarlet fever; constant personal hygiene, hand washing, and wearing a gauze bandage reduce the likelihood of infection to zero.

In order to timely detect the negative effects of streptococcus on the body after recovery, you need to take urine and blood tests after about two to three weeks. The detection of protein and red blood cells in the urine may indicate the development of nephritis, so the doctor will prescribe additional tests to rule it out. An extensive inflammatory process will be manifested by an increase in ESR and leukocytes. The pediatrician is also required to listen to the child’s heart after scarlet fever; this will show in time whether there are changes in the heart muscle. Parents should also pay increased attention to the health of their children after recovery. Deterioration in general health, lethargy, apathy, swelling of the face, poor appetite, a new jump in temperature are compelling reasons to consult a doctor.

The information is provided for informational purposes only. Do not self-medicate. At the first sign of disease, consult a doctor.

Source: http://medlor.ru/zabolevaniya-gorla/skarlatina/vidy-oslozhnenij-pri-skarlatine/

Recurrence of scarlet fever

Relapse of scarlet fever, like most authors, we call the return of all the main initial symptoms of the disease. In most cases, a relapse develops in the 3rd - 4th week of scarlet fever. According to various authors, the frequency of relapses of scarlet fever varies widely - from 0.4 to 4%.

Some authors point to an even higher percentage. This significant difference in numbers is explained mainly by the difference in the content of the concept of “relapse”. Some authors include here secondary tonsillitis, secondary late lymphadenitis, repeated fever waves, etc. The occurrence of relapses and secondary tonsillitis in most cases is associated with reinfection that occurs when the epidemiological regime in the scarlet fever department is violated.

The allergic state of the body, the inferiority of the immune system due to the individual characteristics of the patient, and the addition of various secondary infections such as influenza, chickenpox, etc. are also of great importance.

In the last three decades, the course of scarlet fever has changed significantly; it is characterized by a number of features, which have already been partially mentioned above. Briefly, these features can be characterized as follows. Currently, scarlet fever occurs predominantly in a mild form; the erased form has become more common. Patients with severe clinical forms account for about 1%.

The severity of intoxication (hyperthermia, vomiting, especially repeated, symptoms of damage to the central nervous system, etc.), as well as other pathological changes, decreased significantly. The frequency and severity of septic manifestations of scarlet fever, such as necrotizing tonsillitis, as well as complications, especially purulent-septic ones, have sharply decreased. There are mainly mild complications: secondary catarrhal tonsillitis, catarrhal otitis media, simple lymphadenitis.

The smooth course of the secondary period predominates (i.e., without complications, low-grade fever). Many of these features are largely due to the modern rational method of hospitalization and effective therapy.

The reason for changes in the clinical course of scarlet fever in the initial period is not entirely clear. Perhaps this is due to changes in the properties of the pathogen, with a drop in its virulence, which occur not without the indirect influence of many years of widely used antibiotic therapy.

"Children's infectious diseases"

The clinical picture of scarlet fever is very diverse in terms of severity and nature of manifestations. Along with cases of the mildest rudimentary scarlet fever, there are catastrophic hypertoxic forms. Beyond these extreme forms, there is a wide variety of clinical variants. According to the proposal of a number of domestic authors (V.I. Molchanov, A.A. Koltypin, M.G. Danilevich), the following forms are distinguished according to the severity of scarlet fever: mild, moderate, severe….

The clinical picture of scarlet fever, due to certain deviations from the usual classical symptom complex, may have some similarity with other diseases accompanied by a rash: measles, measles rubella, prodromal rash with chickenpox and natural pox, prickly heat, drug and toxic rashes (toxicoderma), Far Eastern scarlet-like fever and etc. Scarlet fever without a rash can be mixed with various sore throats, in particular with diphtheria...

Moderate form The onset is acute, with a full range of symptoms. Severe intoxication: fever up to 39°C, and on some days even up to 40°C, headache, weakness, malaise, sometimes delirium at night. In the first days of the disease, vomiting is often observed, sometimes multiple times. Tachycardia: pulse up to 140 - 160 per minute. There are no signs of cardiac depression. Catarrhal tonsillitis...

Drug rashes (after taking sulfonamides, antibiotics) have a varied nature. Sometimes they are very similar to scarlet fever. Localization is varied; the skin of the nasolabial triangle also becomes covered with a rash. There are no pinpoint hemorrhages. Subsequent peeling, if it occurs, is usually more pronounced on the trunk. Sore throat, regional lymphadenitis and tongue changes typical for scarlet fever are absent. Often there is an indication in the anamnesis of exposure to one or...

Severe septic form With this form, the phenomena of intoxication recede into the background. The disease is characterized primarily by a severe process in the pharynx (necrotizing tonsillitis), a violent inflammatory reaction from the regional lymph nodes and an extreme frequency of septic complications. Usually, from the 1st day the disease progresses severely: high fever, severe changes in general condition, adynamia. However, often at first the patient’s condition...

Diseases, pathologies, reference books on pediatrics,

Source: http://www.kelechek.ru/detskie_infekcionnaye_bolezni/skarlatina/7789.html

Recurrence of scarlet fever

In most cases, a relapse develops in the 3rd - 4th week of the disease, less often in the earliest period (on the 10th - 11th day) and in the late period (on the 6th - 7th week). The reason for the relapse is reinfection due to a violation of the epidemiological regime in the scarlet fever department.

Of no small importance are the allergic state of the body, a defect in immunogenesis, the addition of various diseases, etc. With a relapse, the main symptoms of scarlet fever reappear.

It is not difficult to diagnose. Previously, relapses were common, but in recent years they have been rare, which is due to the short period of stay of patients in the hospital (10 days) and the work schedule in scarlet fever departments based on the principle of a large box, sharply limiting contacts between patients with different periods of illness and different serovars of streptococcus.

But according to O.A. Tsvetkova (1978), in recent years repeated scarlet fever has become increasingly common. Ovist observed it in 111 (73%) of 153 children. In most patients, scarlet fever occurred in a mild form, and in some it was combined with respiratory infections, a pathological condition of the nasopharynx, etc. It was characterized by a more severe course, an extended febrile period. Multiple cases of scarlet fever are indicated by Kucera and Bauer (1974).

“Guide to airborne infections”, I.K. Musabaev

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Source: http://www.medchitalka.ru/rukovodstvo_po_vozdushno-kapelnym_infekciyam/bakterialnye_infekcii/skarlatina/11030.html

Scarlet fever: complications, consequences and relapse

Scarlet fever was first described as a disease by D. Ingrassia, an Italian doctor in 1954. Translated from English, scarlet fever was called “purple fever.”

  • The causative agent of scarlet fever is group A streptococcus.
  • The same pathogen causes sore throat, erysipelas, rheumatism, tonsillitis, etc.
  • This streptococcus settles in the nasopharynx, causing the development of inflammation.

The source of infection is a person suffering from tonsillitis and, accordingly, scarlet fever. But the source can also be a healthy person (a carrier of infection). The first three days are considered the most dangerous for others. The patient is not dangerous only after 3 weeks after the onset of the disease.

Scarlet fever is transmitted by airborne droplets. Most often, infection occurs if contact with a sick person or carrier is very close. Another route of transmission is contact, through shared objects and dirty hands.

Most cases of scarlet fever have no complications, but sometimes one of the following occurs:

  • ear infection;
  • sore throat;
  • sinusitis;
  • kidney inflammation;
  • otitis media (growth of fluid in the middle ear);
  • pneumonia;
  • rheumatism (joint pain);

Complications of scarlet fever tend to occur only if treatment has failed or if scarlet fever is not treated at all.

Very rare complications of scarlet fever include:

  • meningitis;
  • acute renal (kidney) failure;
  • sepsis (blood poisoning);
  • flesh-eating disease;
  • toxic shock syndrome (a rare, life-threatening bacterial infection);
  • osteomyelitis (infection of the bone and bone marrow).

The disease is common in areas with cold or temperate climates. Children who attend preschool institutions are susceptible to the disease.

Attention

You may have one of the rare effects of scarlet fever if you are very unwell, have a severe headache, vomiting or diarrhea. It is necessary to analyze your condition for the presence of these signs after a week of recovery from scarlet fever.

Knowing the main signs, you can avoid the consequences of scarlet fever:

  1. The patient's temperature rises in the first hours of the disease.
  2. Along with malaise, headache and weakness are observed.
  3. Tachycardia due to increased blood pressure.
  4. Some of the sick are extremely excited and mobile, others, on the contrary, are lethargic and drowsy.
  5. Rarely, vomiting occurs due to intoxication.
  6. Redness of the tonsils and sore throat during eating and swallowing.
  7. In the first few days of illness, the tongue is gray-white. On day 5 it turns red or crimson.
  8. The appearance of a rash, initially on the face and neck. Subsequently, it very quickly spreads to the chest, limbs, and abdomen.
  9. "Palm symptom." With gentle pressure on the skin with your hand, the rash disappears temporarily.
  1. Toxic-septic form. Most often it occurs only in adults. The disease begins very rapidly and is accompanied by all the symptoms described above. Sometimes complications begin in the form of damage to the kidneys, heart, and joints.
  2. Extrabuccal scarlet fever. In this form, the infection enters the body, penetrating through any damage to the skin, including burns, areas of streptoderma, or, for example, wounds. With this form there are no changes in the oropharynx.
  3. Erased forms of the disease. Adults are most susceptible to this form. The symptoms are mild, and the rash disappears quickly.v

If the disease is mild, you can treat it at home. The exception will be moderate and severe forms of disease. Bed rest cannot be broken for 10 days.

Important

Scarlet fever is highly infectious. It spreads through close physical contact or contact with mucous membranes (from coughing or sneezing) of an infected person. Recurrence of scarlet fever is impossible.

If a child has scarlet fever, keep them away from school and away from other people until antibiotics have been taken for at least 24 hours.

Any tissues or handkerchiefs that someone with scarlet fever may have used should be washed or disposed of immediately. Wash your hands completely with soap and water if you touch any of them.

Specialty: Otorhinolaryngologist Work experience: 29 years

Specialty: Audiologist Work experience: 7 years

Source: http://gajmorit.com/skarlatina/oslozhnenija/

Scarlet fever in children

Scarlet fever, or as it was previously called “purple fever,” is an acute infectious disease that occurs with general intoxication, sore throat and skin rash.

Etiology of scarlet fever

Scarlet fever is caused by β - hemolytic streptococci of group A, which are no different from the causative agents of sore throat, erysipelas and other clinical forms of streptococcal infection, and scarlet fever affects people who do not have antitoxic immunity. Predisposition to scarlet fever can be determined by the Dick reaction - intradermal injection of a maximum of 0.2 ml. highly diluted streptococcal toxin. If the reaction is positive, a redness measuring 0.5 - 3 cm will form at the injection site within 24 hours. Subcutaneous injection of large doses of the toxin can lead to symptoms of poisoning.

Scarlet fever most often affects children of preschool and primary school age. Children under one year of age, especially children in the first six months of life, rarely suffer from scarlet fever due to the presence of transplacental immunity and arereactivity to streptococcal toxin. But if they get sick, then with scarlet fever they often develop septic complications: purulent foci appear in various organs. Despite the fact that the general picture of scarlet fever in such children is blurred: the toxic syndrome is mild, the rash is not abundant, and a “crimson tongue” is rarely observed.

From whom can you get scarlet fever?

The source of infection for scarlet fever is adults and children with tonsillitis or nasopharyngitis, and people with chronic diseases of the nasopharynx: nasopharyngitis, tonsillitis.

The infection is transmitted mainly by airborne droplets, but transmission through toys and food is also possible.

The contagiousness of scarlet fever is low. The infectiousness index is 40%.

Is it possible to get scarlet fever again?

After scarlet fever, persistent immunity is usually developed. But the intensity of the immune system may not always be sufficient due to the use of antibiotics for the treatment of patients with scarlet fever. Therefore, cases of repeated scarlet fever have become more frequent.

Symptoms of scarlet fever

The symptoms of scarlet fever depend on its form and phase of the disease.

In the sympathicus phase of scarlet fever (the first seven days of the disease), the tone of the sympathetic nervous system increases. Blood pressure rises above the age norm (systolic pressure for children over one year old is calculated using the formula 90 + 2n, N is the child’s age in years). At the same time, pronounced “white dermographism” is noted.

With toxic scarlet fever, inflammation with superficial necrosis of the epithelium of the tonsils, pharynx, or even the esophagus is observed. With scarlet fever, the spleen, liver, and myocardium also undergo changes. In the brain with scarlet fever, microcirculation is disrupted.

The septic form of scarlet fever is characterized by deeper necrosis and purulent melting of regional lymph nodes. Purulent and septic foci in scarlet fever can be localized in the ear, joints, serous cavities, and kidneys.

Scarlet fever begins acutely two to seven days after contact (sometimes the incubation period is shortened to a day or extended to 12 days).

A patient with scarlet fever has a fever, sore throat and vomiting. After a few hours or on the 2nd day of illness, a rash appears that quickly spreads throughout the body.

How to distinguish a rash with scarlet fever from a rash with measles or rubella?

The rash with scarlet fever is pinpoint, located on an altered (hyperemic) background of the skin, most of the elements of the rash are in the folds of the skin. The nasolabial triangle with scarlet fever remains pale, while the cheeks become bright red. Sometimes the rash merges or looks like blisters filled with clear or cloudy liquid (miliary rash). In severe cases of scarlet fever, the skin takes on a shagreen appearance, or a cyanotic (bluish) tint of the skin appears.

The rash with scarlet fever lasts 3-7 days, then it disappears, leaving no pigmentation, but then peeling of the skin begins.

A constant symptom of scarlet fever is sore throat. “Burning throat”, that’s what they say about a sore throat with scarlet fever. With scarlet fever, tonsillitis can be catarrhal, follicular or necrotic. If necrosis occurs, which has a greenish or dirty gray color, the sore throat lasts up to 10 days. The first two types of sore throat go away in 4-5 days.

At the beginning of the disease, the tongue is covered with a thick gray-yellow coating; after 2-3 days it clears and turns crimson.

The symptom of “raspberry tongue” lasts for 1-2 days with scarlet fever.

The increase in temperature during scarlet fever in severe cases can reach 39 - 40 degrees and above. A patient with scarlet fever is worried about severe headache, uncontrollable vomiting, drowsiness, lethargy, and the possible appearance of meningeal symptoms . In severe cases, the temperature can last up to 7-9 days of illness, but usually it goes away after 2-3 days.

Scarlet fever is also characterized by certain changes in the heart (“scarlet fever”). Cardiovascular disorders last for 2-4 weeks, but sometimes they can drag on for up to 3-6 months.

What complications can there be with scarlet fever?

The most common complications of scarlet fever are lymphadenitis, mastoiditis, nephritis, otitis media, synovitis, sinusitis, and purulent arthritis at 2-3 weeks from the onset of the disease.

Can scarlet fever recur?

Yes they can. Usually within a week of illness, but sometimes they occur during the day, and they are associated with infection with another type of hemolytic streptococcus.

After scarlet fever, children with chronic tonsillitis or rheumatism often experience prolonged low-grade fever.

How to distinguish prickly heat in infants from scarlet fever rash?

With heat rash, the skin is moist rather than dry, and as the baby cools down, the heat rash becomes noticeably paler.

What is the difference between an allergic rash and a scarlet fever rash?

An allergy rash is located on an unchanged skin background; most of the elements of an allergy rash are on the extensor surfaces of the extremities, and it does not spare the nasolabial triangle.

Scarlet fever is best treated at home. Children with severe scarlet fever are hospitalized.

A child suffering from scarlet fever must be provided with a separate room, carefully monitored, and the patient must be provided with appropriate care (a milk-vegetable diet in the first days of the disease, with a gradual transition to a common table, regular ventilation must be carried out, the temperature in the room should not be lower than 20 degrees). The patient's skin must be kept clean. If the process is severe, baths are replaced with rubdowns (solutions of chamomile, string or celandine decoctions).

The oral cavity during scarlet fever can be irrigated with miramistin, an effective antiseptic against gram-positive bacteria, including streptococcus. Miramistin activates regeneration processes and promotes a speedy recovery (individual intolerance to the drug is possible).

For scarlet fever, symptomatic therapy is also carried out.

Antibiotics and antihistamines are prescribed only by a doctor, taking into account tolerance and age-related dosage, but as early as possible in the course of the disease. This serves to prevent complications of scarlet fever.

Prevention of scarlet fever

No specific prevention has been developed for scarlet fever. There are no vaccinations for scarlet fever. All measures come down to early identification of the source of infection and its isolation, strengthening the immune system in children, and hardening.

When can a child go to school or kindergarten after suffering from scarlet fever?

Convalescents are not allowed into the first two grades of school and into kindergartens for twelve days after clinical recovery.

If there were patients with tonsillitis in the scarlet fever outbreak, then they are also not allowed into these institutions for 22 days from the date of their illness.

For how long are you exempt from physical activity after suffering from scarlet fever?

A child who has had uncomplicated scarlet fever is exempt from physical education for 1-2 months. In other cases, the timing of the child’s release from physical activities depends on the type of complication of scarlet fever.

Source: http://happylady.su/skarlatina-u-detey/

Complications of scarlet fever

With scarlet fever, complications develop relatively often and are characterized by great diversity.

The following factors contribute to their occurrence: the presence of chronic inflammatory processes in the pharynx (chronic tonsillitis), flu or measles suffered immediately before scarlet fever, etc.

Complications of scarlet fever are divided into two groups according to the time of their occurrence: early and late. Complications of the first group occur in the initial period of scarlet fever, and the second - in the 3-4th week of the disease.

The frequency of early complications is largely determined by the severity of scarlet fever: they are especially frequent in severe septic and toxic-septic forms of the disease. The dependence of late complications on the severity of the clinical form of scarlet fever is much less pronounced: they occur even with a mild course of the disease.

In addition, the frequency of complications with scarlet fever depends on the age of the patient. Complications most often occur at an early and young age. On the contrary, the older the child, the less often he experiences complications due to scarlet fever, but they are more varied.

Cervical lymphadenitis and adenophlegmon

Moderate swelling of the cervical lymph nodes is an almost constant sign of scarlet fever. However, if the inflammatory process in the cervical lymph nodes is pronounced, then such manifestations are already classified as complications. Cervical lymphadenitis usually develops in the initial period of scarlet fever (usually towards the end of the 1st week of illness) or in the second allergic period.

An even more severe complication of the lymph nodes is adenophlegmon. With this disease, the inflammatory process spreads beyond the boundaries of the lymph nodes to the surrounding tissues: fiber, skin and muscles. Adenophlegmon, as a rule, almost does not complicate the course of scarlet fever and occurs mainly in severe septic and toxic-septic forms of the disease. A patient with this complication takes on a characteristic appearance: extensive inflammatory swelling with blurred contours and dense to the touch quickly forms under the lower jaw on the neck, within which the skin becomes purplish-bluish in color. Inflammatory swelling can spread to the tissues of the face and back of the neck. These phenomena are accompanied by a pronounced disturbance in general health, high fever, and cardiovascular weakness.

In the absence or untimely and incorrect treatment, the prognosis of this complication is unfavorable (even death).

Otitis, or inflammation of the middle ear, occurs both in the initial and in the second, allergic period of scarlet fever (by the end of the 2-3rd week and later). Otitis complicates the course of scarlet fever

2-5% of cases and occurs mainly in young children.

In the absence or irrational treatment, scarlet fever purulent otitis can take a chronic course and even lead to permanent impairment of hearing function.

Sinusitis, or inflammation of the paranasal sinuses, is rare and occurs mainly with septic forms of scarlet fever, in its early period. The inflammatory process is often one-sided and is accompanied by characteristic discharge from one half of the nose.

Pneumonia

Pneumonia is a typical respiratory complication of scarlet fever. In most cases, pneumonia develops in young children. In some cases, the disease occurs as bronchopneumonia.

Nephritis

A typical complication of scarlet fever from the kidneys is diffuse glomerulonephritis, which develops in the second, al-

allergic period of the disease (usually at 3-4 weeks).

In most cases, scarlet fever nephritis complicates the course of severe forms of scarlet fever and begins acutely: the body temperature rises, the general condition of the patient worsens, sleep disturbances, headaches, and occasionally vomiting appear, swelling quickly forms, and blood pressure rises. The daily amount of urine decreases, often taking the form of meat slop. When examining urine (general analysis, Zimnitsky's test), a urinary syndrome typical of nephritis is detected. In the following days, swelling and hypertension increase.

In other cases, the symptoms of nephritis appear over a longer period of time and are often not accompanied by any particular disorder in the patient’s general condition or a sharp rise in temperature. Sometimes there are non-edematous forms of scarlet fever nephritis, in which the main symptoms of the disease (edema, increased blood pressure) are absent. Disturbances in water metabolism can be identified by simply weighing the child. He experiences significant daily weight gain.

In addition, nephritis, occurring with severe hypertension and edema, can be complicated by eclampsia. Sometimes it develops during the stage of subsiding edema. In some cases, eclampsia is preceded by a sharp rise in blood pressure, headache and vomiting. Eclampsia is manifested by a sudden attack of clonic convulsions with loss of consciousness. Such an attack can last from several minutes to several hours. In some cases, after the end of the seizure, temporary loss of vision is determined.

Nephritis lasts on average about 3-6 weeks, sometimes dragging on to 3 months or more. The transition of scarlet fever nephritis to a chronic form is rare.

Synovitis

Synovitis, or joint inflammation, is an uncommon complication of scarlet fever. In most cases, synovitis develops in the 1st-2nd week of illness. As a rule, with scarlet fever synovitis, several joints, both large and small, are gradually affected. The patient's body temperature increases, acute pain and swelling appear in the area of ​​the affected joints, while the color of the skin in these areas does not change.

The described inflammatory phenomena, as a rule, disappear after 2-3 days, but sometimes scarlet fever synovitis drags on for 2 weeks or more.

Recurrence of sore throat and recurrence of scarlet fever

Relapses of tonsillitis occur in the second, allergic, period of the disease. In most cases, secondary angina occurs without necrotic changes. However, there are cases with deep necrotic lesions of the pharynx, severe course and subsequent development of purulent complications.

Recurrence of scarlet fever is manifested by the return of all the main symptoms of the disease and occurs on average in 2-3% of cases. The appearance of a relapse of scarlet fever is observed on average at 3-4 weeks of illness.

The occurrence of relapses of tonsillitis and scarlet fever is mainly associated with a violation of the epidemiological regime, the addition of various secondary infections (influenza, chicken pox, measles, etc.), and inferior immunity due to the individual characteristics of the patient’s body.

In severe forms of scarlet fever, complications may develop from the cardiovascular system (septic myocarditis, occasionally septic endocarditis) and from the central nervous system (toxic hemorrhagic encephalitis, purulent meningitis).

Diagnostics

The diagnosis of scarlet fever is mainly made on the basis of the clinical picture of the disease, taking into account epidemiological data. In cases of the mildest atypical course of the disease, which raises doubts about the diagnosis, an indication of close contact with a patient with scarlet fever tends to recognize the scarlet fever nature of the disease. Among laboratory diagnostic methods, the bacteriological method is used in some cases to confirm the diagnosis. Previously, auxiliary methods were often used to recognize scarlet fever: the phenomenon of rash extinction, Dick's reaction,

The clinical manifestations of scarlet fever have some similarities with other diseases accompanied by a rash, and can be mixed with measles, measles rubella, chickenpox, prickly heat, serum sickness, drug allergies, etc. Scarlet fever without

rashes should be distinguished from various forms of sore throat, diphtheria of the pharynx.

Outcomes and prognosis

The outcome of scarlet fever depends on several factors, primarily the age of the patient and the clinical form of the disease. Accordingly, the younger the patient is and the more severe the course of the disease, the more negative the prognosis and outcome of the disease will be, and vice versa.

Also, the outcome of the disease is directly dependent on the early and correct diagnosis of the disease, the conditions of the patient, the timeliness and rationality of treatment.

Mortality from scarlet fever has recently decreased, but there are still cases of death, the causes of which are mainly associated pneumonia or acute heart failure.

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Scarlet fever - treatment of complications of the disease

Treatment of scarlet fever

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Scarlet fever in children

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Scarlet fever or purple fever is an acute infectious disease. The causative agent of this disease is group A beta-hemolytic streptococcus (Streptococcus pyogenes), which, when producing erythrotoxin, causes the typical symptom complex of scarlet fever.

Factors of influence of streptococcus on the body:

1. Toxic - streptococcus that causes scarlet fever can produce a certain type of toxin in the body, called erythrotoxin (red toxin). This type of toxin can cause the destruction of epidermal cells (epidermolysis) and cause symptoms such as peeling or flaking of the skin, as well as a rash.

2. Septic – the pathogen spreads throughout the body through the bloodstream, thus causing bacteremia.

Scarlet fever causative agent: group A β-hemolytic streptococcus (S.pyogenes)

• Distribution – airborne, contact, food;

• Toxin-producing: erythrotoxin, streptolysin, etc.;

• Streptococcal exotoxin consists of two parts: 1) erythrogenic toxin (heat labile - sensitive to temperature); 2) allergic toxin (thermostable - does not respond to temperature);

• Sensitive to β-lactam antibiotics (penicillins, cephalosporins, carbapenems), resistant to others;

• Stable in the external environment;

• Occurs more often in children from 1 year to 16 years (maximum 3-8 years);

• Contagiousness (susceptibility) – 40% (high), that is, out of 100 people who were in contact with the patient, 40 people get sick.

Entry gates for the causative agent of scarlet fever: mucous membrane of the oropharynx and tonsils + damaged skin.

The causative agent of scarlet fever enters the body:

1) With the help of lipoteichoic acid, streptococcus attaches to lymphocytes and begins active division, releasing erythrotoxin, etc.

2) M-protein (the first virulence factor) suppresses the action of phagocytes, thus preventing the capture of the pathogen and its neutralization.

3) The streptococcal capsule (the second virulence factor) provides resistance against enzymes. It contains hyaluronic acid, which is also found normally in the body's connective tissue, so the immune response to it is minimal. When invading tissue, the streptococcus itself produces hyaluronidase to destroy the capsule and exit it.

4) Circulating in the vascular bed, the pathogen produces toxins and enzymes, such as:

Erythrogenic (pyrogenic) toxin – causes a rash (causes a sharp expansion of capillaries and acute inflammatory reactions of the skin), catarrhal tonsillitis, symptoms of intoxication (fever).

Cardiohepatotoxin - it affects the myocardium, diaphragm, and also promotes the formation of giant cell granulomas in the liver.

Streptolysin (S and O) - damage the cell membrane and cause hemolysis.

The beginning is acute. The incubation period is 1-12 days, more often after 2-7 days. It begins with a rise in high temperature to °C (lasts 3-4 days), sore throat, nausea, sometimes vomiting, and general weakness.

1. Skin with scarlet fever:

After a few hours or towards the end of the day, a pinpoint rash appears against the background of slightly reddened skin (dark red on red), and to the touch the skin can be compared to “goose bumps” or “sandpaper”, since small elements of the rash (roseola up to 1- 2 mm) slightly rise above the surface of the skin. The rash is localized on the lateral surfaces of the torso, flexor surfaces of the arms, legs, axillary and inguinal folds, and lower abdomen. The nasolabial triangle is pale and without rash. Dermographism is white, which appears quickly and disappears within 1-2 minutes. Sometimes there is itching of the skin with scratching.

After 3-4 days, the rash fades away.

From the 7th-9th day of illness, peeling of the skin begins, which lasts for 1-2 weeks. On the face and neck there is fine peeling, on the torso and limbs there are plates, on the palms and soles there are large plates.

Rumpel-Leede symptom (or Konchalovsky-Rumpel-Leede symptom or “tourniquet symptom”) – point linear hemorrhages in areas of skin friction or when a tourniquet is applied.

Pastia's symptom is a more saturated color of the rash in the natural folds of the skin.

2. Oral cavity with scarlet fever:

At the beginning of the disease, the tongue is moist and covered with a white coating, then the coating disappears and well-defined papillae (“crimson tongue”) appear against the background of the bright red tongue.

All signs of a sore throat: the throat is clearly hyperemic (“flaming throat”), there are purulent deposits on the palatine tonsils.

3. Submandibular and cervical lymph nodes are enlarged.

4. Central nervous system:

Damage to the central nervous system manifests itself as:

• impaired consciousness of varying degrees, depending on the severity;

• nausea, vomiting, which does not bring relief;

5. Cardiovascular system: in the first days of the disease, tachycardia, hypertension, and muffled heart sounds are noted, and by the end of the first week of the disease, on the contrary: bradycardia and hypotension.

Forms (severity) of scarlet fever:

1. Mild form – 90% of all cases. Minor intoxication (temperature up to 38°C), no rash, short duration.

2. Moderate - febrile temperature, single vomiting, pronounced rash, tonsillitis (catarrhal or purulent).

3. Severe toxic – high temperature (up to 41 °C), convulsions, confusion, repeated vomiting, signs of meningitis, fainting, tachycardia, hypotension, purulent tonsillitis and, as a consequence, infectious-toxic shock if not detected and treated in a timely manner.

4. Severe septic – the difference from the toxic form is that with septic the process is widespread in the oropharynx. The necrotic process spreads to the soft palate, oropharynx with the involvement of surrounding tissue until the development of periadenitis or adenophlegmon (damage to the lymph nodes).

5. Erased form (subclinical) - characterized by the presence of one or more characteristic signs of scarlet fever.

6. Extrabuccal form (extrapharyngeal) – wound, burn, postpartum scarlet fever. In this form of scarlet fever, streptococcus does not penetrate through the mucous membrane of the oropharynx, but through a wound. There may be a pin-point rash at the site of entry, but the rash may also spread throughout the body. The clinical picture is similar to classic scarlet fever, but there are no symptoms from the oropharynx in the form of tonsillitis, since this is no longer the entry point for infection.

1) Purulent - by frequency: lymphadenitis, otitis media, necrotizing tonsillitis. They may appear regardless of the period of the disease.

2) Allergic (pseudo-relapses) – nephritis, sinusitis, glomerulonephritis. They appear only in the second period (2-3 weeks of the disease), since the allergic reaction develops over time. An allergic reaction may look like the beginning of scarlet fever, and often the doctor’s mistake is to conclude that scarlet fever has recurred, but with an allergic reaction, the rash is not characteristic, although it appears in the same characteristic places. There is also a puffiness of the face and an increase in the level of eosinophils in the peripheral blood.

3) Recurrences of scarlet fever - may appear at 3-4 weeks, sometimes earlier. Relapses may be associated with repeated entry into the child’s body of an infectious agent or with insufficient immunity against the toxin.

4) Cardiovascular complications are divided into three groups:

1) Initial – occur at the moment of greatest intoxication of the body under the influence of a toxin. The degree of damage to the heart muscle depends on the severity of the process.

2) Vagus phase (“scarlet heart”) – by the end of 1 week of the disease. It is physiological in nature. Occurs in response to a violation of the autonomic nervous system and hemodynamic failure. It manifests itself as muffled heart sounds, widening of the boundaries and systolic murmur (relative mitral valve insufficiency), then everything returns to normal.

3) Allergic myocarditis (remote) - occurs at 2-3 weeks of the disease. Not a common occurrence.

5) Late serous polyarthritis - occurs 4-5 weeks after scarlet fever and is a rheumatic attack after scarlet fever. Characterized by damage to large joints and the heart.

Laboratory diagnosis of scarlet fever:

1) Complete blood count (CBC): increased leukocytes and neutrophils, increased ESR - not very informative in terms of making a diagnosis.

2) Tank. inoculation of mucus from the throat (nose) - tank. the analysis is carried out in laboratories on the nutrient medium blood agar - it does not have a high diagnostic value, because streptococcus is present in the pharynx even in healthy children.

3) ELISA - a swab is taken from the throat, treated with luminescent serum and streptococcal antigens are determined.

4) The serological method - the content of anti-O-streptolysin is determined in the blood serum - is informative, but not economical in everyday practice.

5) Dick's reaction (immunobiological test) - intradermal injection of 0.1 ml of hemolytic toxin into the forearm. Interpretation of the result: “+” – the diameter of the papule is 1 cm in children with the onset of the disease. Currently rarely used.

Differential diagnosis of scarlet fever:

1) Measles - The onset is gradual, the first to appear are catarrhal phenomena, the Filatov-Belsky-Koplik symptom, the frequency of the appearance of the rash (first on the face, then on the torso, finally on the limbs), a large-spotted confluent rash on pale skin; in the blood there is a decrease in leukocytes and an increase in lymphocytes.

2) Rubella - no pronounced tonsillitis and changes in the appearance of the tongue, a rash on normal skin in the form of spots, localization of the rash on the outer surfaces (opposite to scarlet fever) and the face; enlargement of the upper cervical and occipital lymph nodes.

3) Staphylococcal infection - sometimes occurs with scarlet fever-like syndrome, but there are fundamental differences that must be taken into account when making a diagnosis. Firstly, the disease begins with an increase in temperature, and the rash appears on days 3-4 (with scarlet fever at the same time). Secondly, with staphylococcal infection there is some primary focus, for example, osteomyelitis or panaritium, etc.

4) Miliaria in young children is a rash on reddened skin in the form of nodules, which turns red when warmed, and turns pale when cooled. There are also no signs of tonsillitis, lymphadenitis or changes in the tongue.

5) Pseudotuberculosis (Far Eastern scarlet-like fever) is a very similar disease, but there are additional symptoms that need to be taken into account when making a diagnosis. This is the appearance of catarrhal phenomena at the onset of the disease, as well as high prolonged temperature and the absence of positive dynamics when using penicillins. The pinpoint rash may form in clusters on the hands (mitten sign), feet (sock sign), and head and neck (hood sign). Differential diagnosis is made using bacterial culture and the serological method.

Treatment of scarlet fever includes neutralization of the pathogen (B - hemolytic streptococcus), as well as the elimination of cases of re- and superinfection in children. Symptomatic therapy is auxiliary, but not without meaning.

Choice: penicillins: Augmentin, Penicillin-G.

  • Cephalosporins: Cefuroxime.
  • Macrolides: Azithromycin (in extreme cases).

2) Antipyretics (NSAIDs) - based on paracetamol.

  • chlorophyllipt in alcohol solution - 1 tsp. per glass of warm water;
  • chlorophyllipt in an oil solution - drop 1-2 drops onto the child’s cheeks 4-5 times a day (suitable for children under 2 years old);
  • chlorophyllipt in a spray - irrigate the throat (for children from 3 years old).

Mortality: Before the discovery of penicillin, mortality was high, but nowadays mortality is observed only in severe forms that were not treated.

Diagnostic features: if the child was not admitted immediately, and the rash has disappeared or is mild, then you need to pay attention to the popliteal fossa, where the rash lasts the longest.

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Scarlet fever in children

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The entry “Scarlet fever in children” was published in the Infection section on Tuesday, January 31st, 2012 at 10:19 pm. The following Tags have been added to the entry: infection, rash

40 comments to the article “Scarlet fever in children”

Hello! Is there a recurrence of scarlet fever? Thank you.

Hello! Happens. Appears more often at 3-4 weeks of illness. But the frequency of occurrence is small and amounts to 4%. Doctors rarely diagnose recurrence of scarlet fever.

Thank you for the clear criteria for the laboratory diagnosis of scarlet fever. I needed an essay.

For those writing essays on the topic “Scarlet fever” - more information to help

Scarlet fever is caused by the bacterium streptococcus, which produces an erythrogenic toxin.

The infection is transmitted from a sick person to a healthy person through small splashes of saliva when talking, coughing, sneezing, as well as through a third party (a person who has come into contact with the patient) and through objects (toys, dishes, etc.). The patient is contagious throughout the entire period of the illness, and can also be a carrier of the bacilli for another 1 month after the illness or more, especially if his nasopharynx and pharynx are inflamed or he suffers from complications with purulent discharge.

Treatment of scarlet fever in children

At the moment, a fairly effective system of measures has been developed that are aimed both at the pathogen itself and at combating intoxication and complications. Thanks to an integrated approach and the advent of antibiotics, it was possible to significantly reduce the incidence of severe forms of the disease and the frequency of complications in scarlet fever.

Sick children are subject to mandatory hospitalization (if it is not possible to isolate the child at home and provide him with appropriate care), not only because of the danger of infecting healthy children, but also in order to prevent purulent complications as a result of a secondary infection. To prevent the transmission of secondary infection from patient to patient, it is advisable to equip scarlet fever departments with wards for 2-3 people, and it is better to hospitalize them for 1-2 days to ensure the most synchronous course of the disease.

Thus, a patient with scarlet fever will have contact with only 1-2 neighbors in the ward (it is necessary to exclude contact with patients from other wards), and, accordingly, his contact with foreign microflora, which can cause secondary purulent complications, will be limited. During the first week, bed rest should be observed. The child’s diet should include food that is appropriate for his age, sufficiently high in calories and rich in all essential nutrients. In severe cases, when feeding a child is difficult (impaired consciousness, frequent vomiting, sore throat when swallowing, etc.), nutrition can begin with a dairy-vegetable diet with maximum mechanical and chemical sparing (it is advisable to limit spicy, sour, fried foods ).

The use of antibiotics has a direct effect on the pathogen. In addition, their use ensures the prevention of purulent complications and re-infection with streptococcus (with the formation of true relapses). In patients who start antibiotic therapy in a timely manner, the infectious period (and, accordingly, the period of hospitalization to 10 days) is sharply reduced, as well as the frequency of allergic reactions, since the rapid elimination of streptococcus from the body prevents allergization of the body (which is confirmed by the rarer positive results of the Dick reaction). The question of the advisability of using antibiotics for mild cases of the disease is still being discussed.

A fairly wide range of antibiotics are used in the treatment of scarlet fever - penicillin, bicillin, biomycin, tetracycline, etc. When prescribing antibiotics to children, both age-related dosages and individual intolerance to a particular drug should be carefully taken into account. The course of treatment for a smooth course is usually 5-7 days.

In cases of severe intoxication (toxic scarlet fever), the use of antitoxic serum obtained from horses that have been injected with scarlet fever streptococcus toxin is indicated, but it is effective only when administered in the first two days of the disease. It must be taken into account that the use of antitoxic serum is indicated exclusively for the toxic form of scarlet fever.

Antibiotics play a leading role in the treatment of scarlet fever. Until now, streptococci remain sensitive to drugs of the penicillin group, which are prescribed in tablet forms at home, and in the hospital - in the form of injections according to age-specific dosages. If a child has intolerance to penicillin antibiotics, erythromycin is the drug of choice.

Is it dangerous to treat scarlet fever with the antibiotic Augmentin in children 6 years old?

Augmentin is one of the antibiotics of choice for treating children even from a younger age.

As far as I understand, is a blood test mandatory for scarlet fever in children? Right?

Tell me what is the causative agent of scarlet fever in children? You have written - β-hemolytic streptococcus group A (S.pyogenes) On other sites: The causative agent of scarlet fever is group A streptococcus. Is this the same pathogen? Help. We need to do a laboratory!

Yes. This is one pathogen. The causative agent of scarlet fever is group A streptococcus, which can also cause kidney damage (glomerulunophritis), sore throat, chronic tonsillitis, rheumatism and other diseases. Scarlet fever occurs if, at the time of infection with streptococcus, there is no immunity to it.

Dear doctors, tell me what diet is needed after scarlet fever if the child has a damaged liver. Please help me create this diet correctly. Very necessary.

You need diet N5. The temperature of hot dishes is 57-62°C, cold - not lower than 15°C. The diet is split, 5-6 times a day.

PROHIBITED: fresh baked goods, including those made from butter dough (cakes, pancakes, pies, pancakes, etc.), soups with meat broths, mushrooms, fatty meats and fish (pork, goose, duck, stellate sturgeon, sturgeon, beluga , catfish), lard, ice cream and cream products, chocolate, hard-boiled and fried eggs. Sour fruits and berries, spinach, sorrel, radishes, radishes, green onions, legumes, mustard, peppers and horseradish are excluded. Pickled vegetables, canned food, smoked meats and caviar are prohibited.

Sample diet menu No. 5.

Oatmeal milk porridge, or cottage cheese with sugar and sour cream. Tea.

Baked apple with honey.

2. Boiled chicken, rice

3. Dried fruit compote (jelly)

Decoction of berries (rose hips). Cracker.

Low-fat boiled fish with white sauce.

At night: acidophilus, kefir, yogurt

Can you say that for scarlet fever in children, observation by a pediatrician should be two or three times a week? Or do I even need to go to a children's hospital?

The child is monitored by a pediatrician, depending on the severity of the infectious process.

Tell me how many times to give Augmentin for scarlet fever? If the child is 3.5 years old? Is it even worth giving Augmentin? They say he is harmful? Can you recommend another medicine for scarlet fever?

Augmentin is just as harmful as other semi-synthetic antibiotics. Therefore, it is considered the standard at the moment.

Tell me, the main method of laboratory diagnosis of scarlet fever is a complete blood count (CBC) - right?

The material for research is mucus from the oropharynx and nasopharynx, pus, wound contents, blood, sputum, and urine. It is inoculated on sugar broth and blood agar.

Dear doctors, please tell me what antibiotics are prescribed for scarlet fever in children?

For scarlet fever, penicillin antibiotics are prescribed.

Dear doctors, please advise how to properly treat relapse of scarlet fever in children?

Relapse of scarlet fever, like most authors, we call the return of all the main initial symptoms of the disease. In most cases, a relapse develops in the 3rd - 4th week of scarlet fever. According to various authors, the frequency of relapses of scarlet fever varies widely - from 0.4 to 4%.

Treatment of scarlet fever in children includes the use of a fairly wide range of antibiotics - penicillin, bicillin, biomycin, tetracycline and other drugs. When prescribing antibiotics to children, age-related dosages and possible individual intolerance to a particular drug should be carefully taken into account. With a “smooth” course of the disease, the course of treatment for scarlet fever in children is usually 5-7 days.

Please help, are tests for scarlet fever very expensive? And are there many of them? Thank you very much in advance.

Usually in our hospitals I don’t take tests for scarlet fever. But the “correct way” is to take at least a general blood test, and ideally an ELISA

I heard that there is a laboratory diagnostic scheme for scarlet fever. Maybe someone knows where to find it?

Scheme for laboratory diagnosis of scarlet fever: for express diagnosis, RCA is used, which detects streptococcal antigens; for standard outpatient cases - a general clinical blood test (leukocytosis, neutrophilia with a shift of the leukocyte formula to the left, increased ESR).

We were told to do a clinical blood test for scarlet fever in children. Now we’re wondering if it’s worth a lot - maybe you can help me. We are waiting for the children's payments to be paid. Just some kind of tears. I wonder if there will be enough for tests? Or did you also want to buy some children’s shoes?

Analysis in a paid laboratory costs about 100 UAH. If in the state, then for 10 UAH they will do it. Do it in the state, while medicine is relatively free, otherwise, if not today, tomorrow our brilliant government will force them to pay for everything officially, and the money, as always, will go into their wallets. And in the hospitals there was nothing, and there will be nothing.

What test needs to be taken to confirm that a child has had scarlet fever? Aslo's title? Or some other one?

Yes. Tirth Aslo shows that the child had a streptococcal infection (not necessarily scarlet fever, but also sore throat or erysipelas). an antibody detection test is done 3-5 weeks after the end of the manifestations of the disease. Only then will it rise. During the active stage of the disease, it has a normal value. If the clinical manifestations of the disease proceed like scarlet fever, then for documentary confirmation you can do an analysis for antibodies produced by the immune system to suppress streptococcal infection, that is, the ASLO titer (abbreviated) or antistreptolysin O.

i.e. there is no analysis that would show that it was scarlet fever?

There is no specific test for scarlet fever. There is a complex of studies, including examination and medical history.

No, listen, this is some kind of kick-ass, not work. Today, at an appointment, one “very competent” mother “drank” a liter of my blood! And the final chord was the question: “How do doctors diagnose scarlet fever? According to the analyses, probably?”

I really wanted to answer - no, damn it, I’m telling fortunes with Tarot cards! If the card falls out, it means scarlet fever; if it doesn’t fall out, it means you’re healthy.

Uuhhh.....my nerves are gone.....

Hello! The child has scarlet fever, today is the 14th day. The course of the disease is not severe. After starting to take the antibiotic (Suprax), the temperature subsided the next day, and the rash went away on the 4th day. But. On the 12th day of the disease (this was just the last, 10th day of taking the antibiotic, but we did not take it), the child developed a rash on his left side in the form of mosquito bites. By evening, the rash turned into red spots and spread over the body. The ambulance that arrived did not make a diagnosis; they gave injections of prednisone and suprastin. At night the spots faded. The next day after lunch the local doctor visited, the spots were still pale. She asked what we ate and said that perhaps it was an allergy to some product. She prescribed Lactofiltrum and Zyrtec (Suprastin). By evening, the spots turned red again and spread over the body (they look like hives). Today, spots have appeared on the face. The child’s temperature is slightly elevated. It's scary to look at a child. What is this? I read that with scarlet fever, allergic waves are possible. But what the rash looks like is not written. If these are allergic waves, how to treat it? When will it pass?

This is possible, either a recurrence of scarlet fever, or a complication in the form of an allergic reaction. Most likely the second. It is treated like an allergy in varying degrees of severity. Perhaps it makes sense to carry out detoxification therapy, inject dexamethasone with supratin, give rehydron and enterosgel (activated carbon, sorbex, smecta). You shouldn't have given up treatment. Due to undertreatment, when they spare the child and stop taking antibiotics halfway, complications usually occur.

Thank you very much. Probably one of the best articles on the topic: “Scarlet fever in children” that I have come across on the Internet. YES, it’s also very informative to read the comments! Added your site to bookmarks. Thank you!

For example, many parents often ask me: “What should be the result of urine and blood in scarlet fever?”

To this I always answer only ONE thing.

A mason must build houses, a baker must bake loaves of bread, and a doctor must heal. If you are not a doctor, then you should not try to learn in 15 minutes what has been taught for about 10 years! (University + Internship + job)

when to get tested after treatment for scarlet fever? In how many days or weeks? Are there any exact rules? Please tell me.

Depends on the severity of the process and the speed of the diagnosis. In practice, a doctor can tell you everything about a specific situation.

They donated blood on the 17th day of scarlet fever. The leukocyte level is 3.2 L 10^3/mm3. The doctor said that it was too short, but did not offer to do anything. Do not re-donate blood after some time, and may not change your diet. What should I do now? Leave the child alone or see another doctor?

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