Scarlet fever in children: symptoms and treatment, photo, prevention
- Risk factors for scarlet fever
- Causes of scarlet fever
- How does the infection occur?
- How does scarlet fever develop?
- What is the prognosis for the patient with scarlet fever?
- Symptoms of scarlet fever in children
- How does the uncomplicated form of scarlet fever occur?
- Diagnosis of scarlet fever
- Treatment of scarlet fever in children
- Prevention of scarlet fever in children
- What else is important to know about scarlet fever?
- What diseases can resemble scarlet fever?
- To what doctor to apply?
According to the definition given by experts in infectious diseases, scarlet fever is called an acute infectious disease that affects mainly children and is characterized by the following pathological symptoms: pronounced intoxication and related deterioration of well-being, angina, characteristic melkoplyatistoy rash. The described disease is dangerous due to its numerous purulent complications.
It is known that such a disease as scarlet fever, was familiar to doctors of the Middle Ages. In the 18-19 centuries, this infectious pathology was described in detail and separated into a separate clinical form.
Most often, children aged 3 to 10 address children for medical help, which is due to two main reasons:
- Imperfection of immune mechanisms of body protection;
- Stay in children's institutions, where there is often a mutual infection.
Children whose age is over 10 years old, as well as adults, susceptibility to infection with streptococcus significantly reduced. This is due to the "growing" of the immune system and the rapid preparation of a unique response of the organism in response to the entry into it of the pathogen. However, this does not exclude the possibility of disease.
It is important to remember that scarlet fever is rarely diagnosed in newborn babies, as well as children of the first year of life. This is due to the presence in their bloodstream of the maternal protective (immune) cells that hit it through the placenta.
Risk factors for scarlet fever
There is a hypothesis according to which children with the following risk factors are most predisposed to the development of this disease:
- Chronic tonsillitis ;
- Atopic dermatitis in children ;
- Various forms of exudative diathesis;
- Reduced body weight (or hypotrophy);
- AIDS or any other impairment of immunity;
- Diabetes mellitus, adrenal gland pathology;
- Chronic pathological changes in the nasopharynx;
- Regular intake of glucocorticosteroids or any other means that reduce the severity of the immune response.
Causes of scarlet fever
To date, it is clearly shown that the causative agent of scarlet fever, both in adults and children, is toxic hemolytic streptococcus, which belongs to group A. This causative agent produces poisonous substances that, when absorbed into the bloodstream, have a pronounced general effect on the entire body. This leads to the appearance in the small patient of signs of intoxication.
Very important is the fact that the above causative agent can cause other diseases in the body, in addition to scarlet fever. Thus, in infected individuals, rheumatism, erysipelas and other pathologies may develop.
Also, attempts were made to justify the role of viruses in the pathogenesis of this infectious disease, but they were unsuccessful.
A healthy carriage of the described variety of streptococcus is also possible. However, in diseased people, the concentration of this bacterium in the blood, urine and washings from the tonsils is hundreds of times higher than in healthy individuals.
How does the infection occur?
The most dangerous for a healthy child is contact with a sick patient who, by sneezing, kissing, talking, coughing, etc., gives him a hemolytic streptococcus.
Despite the fact that you can get infected with such a disease as scarlet fever at any stage of its development in a sick person, the most likely transmission of infection in the acute period of the described pathological condition.
A sufficiently large danger for others is represented by persons with erased and / or asymptomatic forms of scarlet fever. Such persons are estimated by epidemiologists to be about 2/3 of the number of all cases.
The causative agent of the described infection is allocated mainly from the mucus of the oral cavity (or rather the throat), as well as the nasopharynx.
The transfer of scarlet fever from healthy carriers of this disease has no scientific confirmation. Also, the possibility of infection through everyday objects is not proven, as hemolytic streptococcus in the external environment quickly perishes.
A few words about immunity
In most cases, the body produces antibodies not so much in relation to the microorganism itself, as to the toxic substances released to them.
Perhaps two options for the formation of a strong immunity to scarlet fever:
- As a result of an acute infection;
- As a result of frequent repeated contacts with the causative agent of the disease, which, however, did not lead to the development of a clinical picture.
Despite the fact that the majority of persons who have undergone scarlet fever, do not again get this pathology, 1-1.5% of patients become infected again with the development of the corresponding clinical symptoms.
How does scarlet fever develop?
After penetration of the microorganism into the blood, the following sequence of pathological reactions develops:
- A large number of toxins of hemolytic streptococcus is formed;
- Develops an allergic reaction;
- Another infection becomes attached.
The toxic phase is most typical for the initial stages of the development of the disease. Its main signs are disorders of the nervous system, which controls all the systems of the body. This is most clearly manifested at the level of metabolic processes.
The allergic phase is as brightly represented on the 14-21th day of the development of scarlet fever. Clinically, it manifests itself as a fever (wave-like type), palpitations, and various complications (synovitis, nephritis, lymphalenitis, etc.).
The above pathological processes lead to a violation of the barrier function of the skin and mucous membranes, as well as depletion of the mechanisms of immune defense. As a result, other diseases are often added to scarlet fever.
What is the prognosis for the patient with scarlet fever?
Today, scarlet fever almost never leads to death, which is associated with the widespread use of antibiotic therapy.
However, in a certain percentage of clinical situations, infection is extremely difficult. This is especially typical for cases involving primary damage to internal organs (skin, uterus, lungs, etc.). As mentioned above, the entrance gates are household or postoperative wounds.
Symptoms of scarlet fever in children
In most cases, the duration of the incubation period is 3-7 days (sometimes it can go up to 11).
Classically, scarlet fever begins sharply and manifests itself as a rapid rise in body temperature to 39 0 -40 0 С. The condition of the child is complicated by pain when swallowing solid and liquid foods, vomiting, and sometimes nausea. During the first 12 hours from the onset of the disease the skin remains clean, but the touch becomes hot. The rash at this time can be found only in the area of throat. On the skin, pathological changes appear somewhat later and, as a rule, by the end of the 2nd day they are already quite clearly expressed. By the same period, the maximum signs of intoxication and sore throat occur.
The rash in the described disease has its own characteristics. It first appears in the neck, then spreads to the back and upper chest. Most distinctly it is distinguishable on the hands (flexor areas), as well as on the hips on the inside, inguinal folds and lateral parts of the abdomen. In these areas, the rash not only looks brighter, but also lasts longer.
Deserves special attention to the "exclusion zone", where the skin is always clean. They include: the lips, nasolabial triangle, the middle of the face and chin. These areas look very pale against the background of bright red spots of pigmentation. When there are severe signs of rash, it is possible to detect a slight ictericness of the sclera.
The color of the rashes can vary from pale pink to cherry. Externally, they resemble very small dots, but on the folds the rash resembles linear lines (the so-called Pastia symptom). Due to the fragility of the capillaries, hemorrhages can occur in the deep layers of the skin. In most cases, itchy skin is not observed with all the symptoms described above.
Angina is one of the classic signs of scarlet fever. It is manifested by the appearance of a bright red color of throat, as well as films on the tonsils. Clinically, this condition is characterized by difficulty in swallowing, as well as swelling and tenderness when feeling local lymph nodes.
The lips of a child with scarlet fever are dry, constantly cracking. The tongue can be covered with a white-yellow coating. At the same time, from the 3rd day of the disease, it begins to gradually clear from them, as a result of which the tip and edges contrast sharply with the rest of the tongue (it has a crimson-red hue).
Symptoms of intoxication syndrome with scarlet fever are manifested by severe headache, irritability, anxiety. In very severe cases, convulsions may occur. At 60-80% of children with the described disease marked vomiting.
As for the organs of the digestive system, with scarlet fever their function is not violated sharply. For the majority of patients constipation is characteristic, however, infants are more likely to have diarrhea.
How does the uncomplicated form of scarlet fever occur?
From 4-5 days the symptoms of the disease begin to undergo the reverse development: the intensity of intoxication weakens, the temperature decreases. By day 5-7, light forms of angina are completely resolved. The language is completely cleared by 10-14 days of the disease. As for the rash, it should completely disappear by 5-7 days (pigmentation after it should not remain).
From the end of the second week of scarlet fever, there is peeling, which is especially pronounced in the auricles, neck, pubic region and axillae. Especially large layers of skin can go on the palms, fingers and toes. As a rule, the scaling completely passes through 14-21 days from the appearance of the first signs of scarlet fever.
Diagnosis of scarlet fever
Despite the fact that an experienced pediatrician can diagnose a general examination (the leading symptoms are characteristic rash and angina), it is recommended to perform the following diagnostic program:
- Clinical (general) blood test (with scarlet fever, there is an increase in different populations of leukocytes, especially neutrophils and eosinophils., In most cases, the value of ESR also increases significantly).
- Smear on the definition of microflora of throat (typical allocation of streptococcus group A when sowing the resulting biological material on nutrient media).
- The analysis of blood (venous) with the determination of the antibody titer to the causative agent of scarlet fever. This study is conducted in dynamics to determine the immunological readiness of the organism.
Treatment of scarlet fever in children
As already mentioned above, the main thing in the treatment of scarlet fever is the correct and timely appointment of antibacterial agents. Preference in this case is given to analogues of penicillin ( amoxicillin ) or macrolide group (azithromycin). In especially severe cases, cephalosporins (ceftriaxone) may be attributed.
In order to alleviate the severity of the child's condition, it is necessary to prescribe drugs with detoxification effect. In scarlet fever with a severe and moderate course, intravenous infusions are indicated. If the child does not have indications for hospitalization, then it is necessary to organize a proper drinking regime at home. The volume of fluid should be determined by the attending physician, taking into account the age of the baby.
Since streptococci secretes a large number of toxins, the child must take antiallergic drugs. It should be remembered that their choice must be approached with extreme caution, since many of them are contraindicated for children under 12 years old.
At high temperature, the child should be given anti-inflammatory drugs. Remember that the use of aspirin in children's practice is prohibited! Recommended ibuprofen or paracetamol.
If there are small hemorrhages, then it is possible to recommend means that strengthen the wall of blood vessels. These include a well-known drug called ascorutin.
Prevention of scarlet fever in children
The best way to protect yourself from infection is to wash your hands often with soap and water. Also, you should avoid sharing dishes with the patient, towels and other personal items.
In addition, young children are taught from childhood to teach that when they sneeze and cough they cover their mouths in order to prevent the possible spread of microbes. If a child has an infection on the skin caused by streptococcal bacteria, she can also switch to other people. It is necessary to handle a cup, a plate and a spoon of the child. Processing consists in soaking dishes (soap boiling water).
In everyday life, there is no ideal way to avoid infections that cause scarlet fever. When the child is sick and is at home - it is safest to keep the dishes of the baby apart from other family members. Mom, whose baby is sick, it is recommended to wash hands at least 5 times a day. There are still important factors that affect the infection with scarlet fever. It:
- Genetic predisposition;
- Previous diseases (angina);
- Environmental factor (poor sanitation, overcrowding and lack of clean water).
To the child had little chance of getting scarlet fever, it is necessary to treat the angina in time and to the end in due time. Another important point is finding a pregnant woman in the home during a period of illness in the child. This is dangerous for both the future mother and the baby. Doctors advise a woman to walk in a mask, and the sick child is at least in the next room.
What else is important to know about scarlet fever?
- Despite the fact that hemolytic streptococcus is the causative agent of quite a large number of infections, and also causes the severity of the condition with scarlet fever, it can be easily treated with antibacterial drugs.
- If the medicine is selected correctly, then the child's relief may come after 24-48 hours.
- For mild forms of the disease, which are satisfactorily borne by the child, hospitalization in an infectious hospital is not required.
- It is advisable that, after the disease, the child no longer has any contact with persons infected with streptococcus. Otherwise, the risk of allergic and infectious complications is high.
- The outcome of scarlet fever can be twofold. With the timely start of antibiotic therapy, almost all children recover without any undesirable consequences for the body. However, if the treatment was wrong and / or untimely, then the risk of complications is extremely high.
- Antibacterial drugs help to cure the disease in a short time, but they interfere with the normal production of antibodies. This is due to the very rapid removal of streptococcus from the body. As a result, a recurrent disease can develop which, in most cases, occurs either in a very mild form or without any symptoms.
- After complete cure, the child should not contact other children or attend organized groups (clubs, gardens, schools) for at least 21-22 days.
What diseases can resemble scarlet fever?
To what doctor to apply?
The treatment of such a disease as scarlet fever is done by a children's infectious disease specialist.
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