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Scarlet Fever

Scarlet fever

Definition

Scarlet fever is an infection caused by a streptococcus bacterium. It can be transmitted through the air or by physical contact and primarily affects children between four and eight years of age. In temperate climates, scarlet fever is most common during the late fall, winter, and early spring.

Scarlet fever is characterized by a sore throat , a fever of 103104°F (39.440°C), and a sandpaper-like rash on reddened skin. If scarlet fever is untreated, such serious complications can develop; as rheumatic fever (a heart disease ) or kidney inflammation (glomerulonephritis).

Description

Scarlet fever, or scarlatina, gets its name from the characteristic flush of the patient's skin, especially on the cheeks. Fever and sluggishness accompany a sore throat and raised rash that progressively covers much of the body. Symptoms usually begin within two to five days after a person is exposed. The fever usually subsides within a few days, and recovery is complete by two weeks. After the fever is gone, the skin on the face and body forms flakes, with the skin on the palms of the hands and soles of the feet peeling more dramatically.

Scarlet fever is highly contagious when the patient is in the early stages and is not being treated with antibiotics. It is spread by sneezing , coughing, or direct contact with an infected person. Early in the twentieth century, severe scarlet fever epidemics were common. As of the early 2000s, the disease is rare, partially because of the availability of antibiotics. However, antibiotics are not the entire reason, since the decline began before their widespread use. One theory is that the strain of bacteria that causes scarlet fever has become weaker over time.

Causes & symptoms

Scarlet fever is caused by Group A streptococcal bacteria (Streptococcus pyogenes ). In addition to causing scarlet fever, Group A streptococci bacteria cause many different illnesses, such as strep throat , wound or skin infections, pneumonia , serious kidney infections , and toxic shock syndrome . The strain of streptococcus that causes scarlet fever is slightly different from the strain that causes most strep throats. The scarlet fever strain produces an erythrogenic toxin, which is what causes the skin to turn red.

The main symptoms and signs of scarlet fever are fever, sluggishness, sore throat, and a bumpy rash that blanches (turns white) when it's pressed. The rash appears first on the upper chest and spreads to the neck, abdomen, legs, arms, and in folds of skin such as under the arm or in the groin. The skin around the mouth tends to be pale while the cheeks are flushed. In children, the disease causes a "strawberry tongue," in which inflamed bumps on the tongue rise above a bright red coating. Strawberry tongue is rarely seen in adults. Finally, dark red lines (called Pastia's lines) may appear in the creases of skin folds.

Diagnosis

A medical practitioner must diagnose and treat scarlet fever. The doctor notes the symptoms and eliminates

the possibility of other diseases. Measles is a viral infection that is also associated with a fever and rash. However, scarlet fever can be distinguished from measles by the quality of the rash, the presence of a sore throat in scarlet fever, and the absence of the severe eye inflammation and runny nose that usually accompany measles.

Because scarlet fever may begin with a sore throat, the doctor will first determine if the problem is bacterial or viral in nature by checking for specific symptoms. For example, inflammation of the lymph nodes in the neck is typical in strep infections but not viral infections. On the other hand, cough, laryngitis , and stuffy nose tend to be associated with viral infections rather than strep infections.

Laboratory tests are necessary to make a definitive diagnosis of a strep infection and to distinguish a strep throat from a viral sore throat. One test that can be performed is a blood cell count. Bacterial infections are associated with an elevated white blood cell count. In viral infections, the white blood cell count is generally below normal. A throat culture can distinguish between a strep infection and a viral infection. A throat swab from the infected person is brushed over a nutrient gel containing red blood cells (a sheep blood agar plate) and incubated overnight. If streptococcal bacteria are present in the sample, they will break down the red blood cells and leave a clear zone in the gel surrounding the bacteria.

The doctor will also distinguish between a strep throat and scarlet fever. In a strep infection, the throat is sore and appears beefy and red. White spots appear on the tonsils. Lymph nodes under the jaw line may swell and become tender. These symptoms may or may not be present with scarlet fever. The main feature that distinguishes scarlet fever from a strep throat is the presence of the sandpapery red rash.

Treatment

Because of the nature of the infection and the danger of serious complications, scarlet fever cannot be treated solely with alternative therapies. A course of antibiotics and treatment by a physician is imperative. However, alternative therapies may be used to relieve the symptoms of fever and sore throat.

Fever

For fever, especially in children, there are some alternative treatments. Naturopathy recommends sponging with tepid water if the fever rises over 102°F (38.9°C). Rest and plenty of water are advised.

Homeopathy treats the specific type of fever, so it will be necessary to consult with a homeopath to determine the correct remedy for the patient. Some common homeopathic remedies for fever are:

  • Aconite 6c at the onset of fever that is accompanied by thirst, chills , dry burning skin, and restlessness.
  • Belladonna 6c for high fever with dry burning skin, red face, dilated pupils, and swollen glands.
  • Arsenicum album 6c for patients who are restless and agitated, alternately hot and cold, thirsty, and patients whose fever is worse after midnight.
  • Byronia 6c for the patient who is shivery and sweating, very thirsty at long intervals, and having headaches and pain .
  • Ferrum phosphoricum (iron phosphate) 6c for a mild fever of slow onset accompanied by frequent bouts of sweating, shivering, and headaches.

Western herbalism may be used to treat fever, but treatment requires a qualified medical herbalist. The herbalist may recommend a bath with tepid infusions of limeflower, elderflower, yarrow , or German chamomile . Herbs such as catnip, hyssop, lemon balm , and vervain can lower the temperature and increase perspiration. German chamomile, lavender , and limeflower promote relaxation , and echinacea and garlic fight infection.

Chinese herbs in combinations can treat specific patterns of fever. They can also be used to balance the energies, specifically the yin (cool and moist) energies after the illness subsides.

Sore throat

Some recommended treatments for sore throat are:

  • Aromatherapy, in which the patient gargles with water and very small amounts of geranium or tea tree essential oils . A massage using diluted eucalyptus oil may also be helpful.
  • Naturopathy may suggest fasting to eliminate toxins and the use of garlic to fight infection. Naturopaths will also recommend fruit juices high in vitamin C , especially citrus fruit juices, to soothe irritation.
  • Hydrotherapy, in which water is utilized to restore health, uses humidifiers to prevent the irritation of a sore throat by dry air. A practitioner may also recommend using a cold abdominal pack and throat compress to stimulate both circulation and the immune system.
  • Western herbalists will recommend gargling with an infusion of antiseptic herbs such as calendula or sage , and may use echinacea to fight infection.

Allopathic treatment

Although the symptoms of scarlet fever often clear within a few days, the patient should receive antibiotic treatment to reduce the severity of symptoms, prevent complications, and avoid spreading the infection to others. Antibiotics may be taken either orally or by injection. After a patient has been on antibiotics for 24 hours, he or she is no longer contagious. The rash itself is not contagious. Antibiotic treatment will shorten the course of the illness in small children but may not do so in adolescents or adults. Nevertheless, a full course of treatment with antibiotics is important for preventing complications.

Since penicillin injections are painful, oral penicillin may be preferable. If the patient is unable to tolerate penicillin, alternative antibiotics such as erythromycin or clindamycin may be substituted. The patient must take the entire course of medicationusually 10 daysfor the therapy to be effective and to ensure that the bacteria have been killed. Because symptoms subside quickly, there is a temptation to stop therapy prematurely. However, not completing the medication increases the risk of developing rheumatic fever and kidney inflammation. If the patient is considered too unreliable to take all of the pills or is unable to take oral medication, daily injections of procaine penicillin can be given in the hip or thigh muscle.

After the contagious period has passed, the patient does not need to be isolated. Bed rest is not necessary. Aspirin or Tylenol (acetaminophen) may be given for fever or pain relief.

Expected results

If the patient is treated promptly with antibiotics, full recovery can be expected. Patients who have had scarlet fever develop immunity to the disease and cannot be infected again. However, about 10% of children don't respond to an initial antibiotic treatment, so it may be necessary for a second throat culture and the use of a different antibiotic.

Prevention

Although scarlet fever is only contagious before treatment with antibiotics is begun, it is wise to avoid exposure to children at any stage of the disease. Doing so will help prevent the spread of scarlet fever.

Resources

BOOKS

Berkow, Robert M.D., ed. The Merck Manual of Diagnosis and Therapy. 16th ed. Rahway, NJ: Merck, 1992.

Driscoll, John. "Scarlet Fever." In The Columbia University College of Physicians and Surgeons Complete Home Medical Guide. 3rd rev. ed. New York: Crown Publishers, 1995.

Woodham, Anne, and David Peters, M.D. Encyclopedia of Healing Therapies. New York: DK Pub., 1997.

Wyngaarden, James B., Lloyd H. Smith, and J. Claude Bennett, eds. Cecil Textbook of Medicine. 19th ed. New York: W.B. Saunders Company, 1992.

PERIODICALS

Gregory, Tanya. "Scarlet Fever and Its Relatives." Patient Care (June 15, 1998): 109.

Schmitt, B. D. "Scarlet Fever" Clinical Reference Systems (July 1, 1999): 1293.

Amy Cooper

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Scarlet Fever

Scarlet Fever

Definition

Scarlet fever is an infection that is caused by a bacteria called streptococcus. The disease is characterized by a sore throat, fever, and a sandpaper-like rash on reddened skin. It is primarily a childhood disease. If scarlet fever is untreated, serious complications such as rheumatic fever (a heart disease) or kidney inflammation (glomerulonephritis ) can develop.

Description

Scarlet fever, also known as scarlatina, gets its name from the fact that the patient's skin, especially on the cheeks, is flushed. A sore throat and raised rash over much of the body are accompanied by fever and sluggishness (lethargy). The fever usually subsides within a few days and recovery is complete by two weeks. After the fever is gone, the skin on the face and body flakes; the skin on the palms of the hands and soles of the feet peels more dramatically.

This disease primarily affects children ages two to ten. It is highly contagious and is spread by sneezing, coughing, or direct contact. The incubation period is three to five days, with symptoms usually beginning on the second day of the disease, and lasting from four to ten days.

Early in the twentieth century, severe scarlet fever epidemics were common. Today, the disease is rare. Although this decline is due in part to the availability of antibiotics, that is not the entire reason since the decline began before the widespread use of antibiotics. One theory is that the strain of bacteria that causes scarlet fever has become weaker with time.

Causes and symptoms

Scarlet fever is caused by Group A streptococcal bacteria (S. pyogenes ). Group A streptococci can be highly toxic microbes that can cause strep throat, wound or skin infections, pneumonia, and serious kidney infections, as well as scarlet fever. The Group A streptococci are; hemolytic bacteria, which means that the bacteria have the ability to lyse or break red blood cells. The strain of streptococcus that causes scarlet fever is slightly different from the strain that causes most strep throats. The scarlet fever strain of bacteria produces a toxin, called an erythrogenic toxin. This toxin is what causes the skin to flush.

The main symptoms and signs of scarlet fever are fever, lethargy, sore throat, and a bumpy rash that blanches under pressure. The rash appears first on the upper chest and spreads to the neck, abdomen, legs, arms, and in folds of skin such as under the arm or groin. In scarlet fever, the skin around the mouth tends to be pale, while the cheeks are flushed. The patient usually has a "strawberry tongue," in which inflamed bumps on the tongue rise above a bright red coating. Finally, dark red lines (called Pastia's lines) may appear in the creases of skin folds.

GLADYSDICK (18811963)

Before 1922, not much was known about the then-endemic disease of scarlet fever, which primarily affected children in Europe and North America, killing about 25% of the children who contracted it. Additionally, scarlet fever had many complications, some of which were severe and could be crippling. Gladys Dick, with her husband, George Dick, successfully isolated the bacteria which caused scarlet fever, developed a test for human vulnerability to the disease, and devised preventive methods. The couple patented their findings, specifically the way their scarlet fever toxin and antitoxin were prepared, although this decision was controversial at the time.

In 1923, the Dicks published papers in which they proved that scarlet fever was caused by hemolytic streptococcus. Within a few years, the Dicks also published papers on how to prevent, test, diagnose, and treat scarlet fever. Their groundbreaking work ensured that the disease was finally understood and brought under control.

Dick and her husband announced the development of what came to be known as the Dick test in 1924. This skin test showed whether the patient was susceptible or immune to scarlet fever. The test involved injecting a toxin-containing substance in the arm and determining if the skin around the area became inflamed. If it did, the patient was vulnerable to scarlet fever. This test was also useful in predicting if pregnant women would develop puerperal infection during childbirth.

Diagnosis

Cases of scarlet fever are usually diagnosed and treated by pediatricians or family medicine practitioners. The chief diagnostic signs of scarlet fever are the characteristic rash, which spares the palms and soles of the feet, and the presence of a strawberry tongue in children. Strawberry tongue is rarely seen in adults.

The doctor will take note of the signs and symptoms to eliminate the possibility of other diseases. Scarlet fever can be distinguished from measles, a viral infection that is also associated with a fever and rash, by the quality of the rash, the presence of a sore throat in scarlet fever, and the absence of the severe eye inflammation and severe runny nose that usually accompany measles.

The doctor will also distinguish between a strep throat, a viral infection of the throat, and scarlet fever. With a strep infection, the throat is sore and appears beefy and red. White spots appear on the tonsils. Lymph nodes under the jawline may swell and become tender. However, none of these symptoms are specific for strep throat and may also occur with a viral infection. Other signs are more characteristic of bacterial infections. For example, inflammation of the lymph nodes in the neck is typical in strep infections, but not viral infections. On the other hand, cough, laryngitis, and stuffy nose tend to be associated with viral infections rather than strep infections. The main feature that distinguishes scarlet fever from a mere strep throat is the presence of the sandpaper-red rash.

Laboratory tests are needed to make a definitive diagnosis of a strep infection and to distinguish a strep throat from a viral sore throat. One test that can be performed is a blood cell count. Bacterial infections are associated with an elevated white blood cell count. In viral infections, the white blood cell count is generally below normal.

A throat culture can distinguish between a strep infection and a viral infection. A throat swab from the infected person is brushed over a nutrient gel (a sheep blood agar plate) and incubated overnight to detect the presence of hemolytic bacteria. In a positive culture, a clear zone will appear in the gel surrounding the bacterium, indicating that a strep infection is present.

Treatment

Although scarlet fever will often clear up spontaneously within a few days, antibiotic treatment with either oral or injectable penicillin is usually recommended to reduce the severity of symptoms, prevent complications, and prevent spread to others. Antibiotic treatment will shorten the course of the illness in small children but may not do so in adolescents or adults. Nevertheless, treatment with antibiotics is important to prevent complications.

Since penicillin injections are painful, oral penicillin may be preferable. If the patient is unable to tolerate penicillin, alternative antibiotics such as erythromycin or clindamycin may be used. However, the entire course of antibiotics, usually 10 days, will need to be followed for the therapy to be effective. Because symptoms subside quickly, there is a temptation to stop therapy prematurely. It is important to take all of the pills in order to kill the bacteria. Not completing the course of therapy increases the risk of developing rheumatic fever and kidney inflammation.

KEY TERMS

Clindamycin An antibiotic that can be used instead of penicillin.

Erythrogenic toxin A toxin or agent produced by the scarlet fever-causing bacteria that causes the skin to turn red.

Erythromycin An antibiotic that can be used instead of penicillin.

Glomerulonephritis A serious inflammation of the kidneys that can be caused by streptococcal bacteria; a potential complication of untreated scarlet fever.

Hemolytic bacteria Bacteria that are able to burst red blood cells.

Lethargy The state of being sluggish.

Pastia's lines Red lines in the folds of the skin, especially in the armpit and groin, that are characteristic of scarlet fever.

Penicillin An antibiotic that is used to treat bacterial infections.

Procaine penicillin An injectable form of penicillin that contains an anesthetic to reduce the pain of the injection.

Rheumatic fever A heart disease that is a complication of a strep infection.

Sheep blood agar plate A petri dish filled with a nutrient gel containing red blood cells that is used to detect the presence of streptococcal bacteria in a throat culture. Streptococcal bacteria will lyse or break the red blood cells, leaving a clear spot around the bacterial colony.

Strawberry tongue A sign of scarlet fever in which the tongue appears to have a red coating with large raised bumps.

If the patient is considered too unreliable to take all of the pills or is unable to take oral medication, daily injections of procaine penicillin can be given in the hip or thigh muscle. Procaine is an anesthetic that makes the injections less painful.

Bed rest is not necessary, nor is isolation of the patient. Aspirin or Tylenol (acetaminophen) may be given for fever or relief of pain.

Prognosis

If treated promptly with antibiotics, full recovery is expected. Once a patient has had scarlet fever, they develop immunity and cannot develop it again.

Prevention

Avoiding exposure to children who have the disease will help prevent the spread of scarlet fever.

Resources

BOOKS

Bennett, J. Claude, and Fred Plum, editors. Cecil Textbook of Medicine. Philadelphia: W. B. Saunders Co., 1996.

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Jacobs, Sally. "Scarlet Fever." Gale Encyclopedia of Medicine, 3rd ed.. 2006. Encyclopedia.com. 28 Jul. 2016 <http://www.encyclopedia.com>.

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Jacobs, Sally. "Scarlet Fever." Gale Encyclopedia of Medicine, 3rd ed.. 2006. Retrieved July 28, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3451601444.html

Scarlet Fever

Scarlet fever

Definition

Scarlet fever is a rash that complicates a bacterial throat infection called strep throat .

Description

Scarlet fever, also known as scarlatina, gets its name from the fact that the patient's skin, especially on the cheeks, is flushed. The disease primarily affects children. A sore throat and a raised, sandpaper-like rash over much of the body are accompanied by fever and sluggishness (lethargy). The fever usually subsides within a few days, and recovery is complete by two weeks. After the fever is gone, the skin on the face and body flakes; the skin on the palms of the hands and soles of the feet peels more dramatically. Treatment for scarlet fever is intended to offset the possibility of serious complications such as rheumatic fever (a heart disease) or kidney inflammation (glomerulonephritis) can develop.

Scarlet fever is highly contagious and is spread by sneezing, coughing, or direct contact. The incubation period is three to five days, with symptoms usually beginning on the second day of the disease and lasting from four to ten days.

Early in the twentieth century, severe scarlet fever epidemics were common. In the early 2000s, the disease is rare. Antibiotics have helped, and it is possible that the strain of bacteria that causes scarlet fever has become weaker with time.

Demographics

Scarlet fever primarily affects children between the ages of five and 15 years. Approximately 10 percent of all children who have strep throat develop the characteristic scarlet fever rash.

Causes and symptoms

Scarlet fever is caused by group A streptococcal bacteria (S. pyogenes ), highly toxic microbes that can also cause strep throat, wound or skin infections, pneumonia , and serious kidney infections. The group A streptococci are hemolytic bacteria, which means that they have the ability to break red blood cells. The strain of streptococcus that causes scarlet fever, unlike the one that causes most strep throats, produces an erythrogenic toxin, which causes the skin to flush.

The main symptoms and signs of scarlet fever are fever, lethargy, sore throat, and a bumpy rash that blanches under pressure. The rash appears first on the upper chest and spreads to the neck, abdomen, legs, arms, and in folds of skin such as under the arm or groin. In scarlet fever, the skin around the mouth tends to be pale, while the cheeks are flushed. The patient usually has a "strawberry tongue," in which inflamed bumps on the tongue rise above a bright red coating. Finally, dark red lines (called Pastia's lines) may appear in the creases of skin folds.

Diagnosis

Cases of scarlet fever are usually diagnosed and treated by pediatricians or family medicine practitioners. The chief diagnostic signs of scarlet fever are the characteristic rash, which spares the palms and soles of the feet, and the presence of a strawberry tongue in children. Strawberry tongue is rarely seen in adults.

The doctor will take note of the signs and symptoms to eliminate the possibility of other diseases. For example, scarlet fever can be distinguished from measles , a viral infection that is also associated with a fever and rash, by the quality of the rash, the presence of a sore throat in scarlet fever, and the absence of the severe eye inflammation and severe runny nose that usually accompany measles.

Treatment

Although scarlet fever often clears up spontaneously within a few days, antibiotic treatment with either oral or injectable penicillin is usually recommended to reduce the severity of symptoms, prevent complications, and prevent spread to others. Antibiotic treatment shortens the course of the illness in small children but may not do so in adolescents or adults. Nevertheless, treatment with antibiotics is important to prevent complications.

One benzathine penicillin injection is required for treatment. But since penicillin injections are painful, oral penicillin may be preferable. If the patient is unable to tolerate penicillin, alternative antibiotics such as erythromycin or clindamycin may be used. However, the entire course of antibiotics, usually ten days, needs to be followed for the therapy to be effective. Because symptoms subside quickly, there is a temptation to stop therapy prematurely. It is important to take all of the pills in order to kill the bacteria. Not completing the course of therapy increases the risk of developing rheumatic fever and kidney inflammation.

Bed rest is not necessary, nor is isolation of the patient. Acetaminophen may be given for fever or relief of pain .

Prognosis

If treated promptly with antibiotics, full recovery is expected. Once a patient has had scarlet fever, the person develops immunity and cannot develop it again.

Prevention

Avoiding exposure to children who have the disease helps prevent the spread of scarlet fever.

Parental concerns

The most important thing to do for children with scarlet fever is to carefully and completely follow the healthcare provider's instructions for administering a course of antibiotics.

See also Strep throat.

Resources

WEB SITES

Balentine, Jerry. "Scarlet Fever." eMedicine, November 2, 2004. Available online at <www.emedicine.com/emerg/topic518.htm> (accessed December 30, 2004).

Goldenring, John. "Scarlet Fever." MedlinePlus, November 11, 2003. Available online at <www.nlm.nih.gov/medlineplus/ency/article/000974.htm> (accessed December 30, 2004).

ORGANIZATIONS

American Academy of Pediatrics. 141 Northwest Point Blvd., Elk Grove Village, IL 60007-1098. Web site: <www.aap.org>.

Sally J. Jacobs, EdD Rosalyn Carson-DeWitt, MD

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Jacobs, Sally; Carson-DeWitt, Rosalyn. "Scarlet Fever." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Encyclopedia.com. 28 Jul. 2016 <http://www.encyclopedia.com>.

Jacobs, Sally; Carson-DeWitt, Rosalyn. "Scarlet Fever." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Encyclopedia.com. (July 28, 2016). http://www.encyclopedia.com/doc/1G2-3447200501.html

Jacobs, Sally; Carson-DeWitt, Rosalyn. "Scarlet Fever." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Retrieved July 28, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3447200501.html

scarlet fever

scarlet fever or scarlatina, an acute, communicable infection, caused by group A hemolytic streptococcal bacteria (see streptococcus) that produce an erythrogenic toxin. The disease is now uncommon, probably because antibiotic therapy has lessened the likelihood of spread. It occurs in young children, usually between two and eight years of age, and is spread by droplet spray from carriers and from individuals who have contracted the disease. The incubation period is from three to five days, and infectivity lasts about two weeks. Scarlet fever may be mild or severe, but it is rarely fatal if treated. Typical symptoms are sore throat, headache, fever, flushed face with a ring of pallor about the mouth, red spots in the mouth, coated tongue with raw beefy appearance and inflamed papillae underneath it (strawberry tongue), and a characteristic eruption on the body. The streptococcal bacterium that causes scarlet fever is identical to the streptococcal pharyngitis (strep throat) organism, the difference being the production of a toxin to which the patient is susceptible in the case of scarlet fever. Severe infections are occasionally complicated by rheumatic fever, kidney disease, ear infection, pneumonia, meningitis, or encephalitis. Mild scarlet fever requires only bed rest, antibiotics, analgesics or antipyretics, and symptomatic treatment. Antibiotics, immune serum, and antitoxin may be required for severe cases.

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Scarlet Fever

SCARLET FEVER

DEFINITION


Scarlet fever is an infection caused by a bacterium called Streptococcus (pronounced strep-tuh-KOK-us). The disease is characterized by a sore throat (see sore throat entry), fever, and a sandpaper-like rash on reddened skin. It is primarily a childhood disease. If scarlet fever is not treated, serious complications, including rheumatic fever (a heart disease; see rheumatic fever entry) and inflammation of the kidney, can result.

DESCRIPTION


Scarlet fever gets its name from the appearance of the patient's skin, especially around the cheeks, which becomes red and flushed. Scarlet fever is accompanied by a sore throat, fever, sluggishness, and a raised rash over much of the body.

The fever that accompanies scarlet fever usually lasts only a few days. By the end of two weeks, the disease has usually run its course. At that point, skin begins to peel off. The most dramatic peeling occurs on the palms of the hands and the soles of the feet.

Scarlet Fever: Words to Know

Antibiotic:
A substance derived from bacteria or other organisms that fights the growth of other bacteria or organisms.
Streptococcus :
A class of bacteria that causes a wide variety of infections including scarlet fever.

Scarlet fever primarily affects children ages two to ten. It is highly contagious and is spread by sneezing, coughing, or direct contact. The incubation period is three to five days. The incubation period is the time between infection and the first appearance of symptoms. The symptoms of scarlet fever usually last four to ten days.

At one time, scarlet fever was a very common disease, but it has since become quite rare. This is due in part to the availability of antibiotics that are able to kill off the infection. Some scientists believe another reason for the decline is that the organism that causes scarlet fever became weaker.

CAUSES


Scarlet fever is caused by an organism known as Group A streptococcal bacterium. Other organisms of this kind also cause sore throats, skin infections, pneumonia (see pneumonia entry), and serious kidney infections. The bacteria that cause scarlet fever produce a toxin (poison) that causes skin to turn red.

SYMPTOMS


The main symptoms of scarlet fever are fever, lethargy (sluggishness), sore throat, and a bumpy rash that turns white under pressure. The rash first appears on the upper chest then spreads to the neck, abdomen, legs, arms, armpits, and groin. The patient's cheeks become flushed, but the skin around the mouth tends to be pale. The patient usually has a "strawberry tongue." This name comes from the fact that there are inflamed bumps on the tongue on top of a bright red coating.

DIAGNOSIS


Diagnosis of scarlet fever also depends on eliminating other possible diseases with similar symptoms. For example, measles (see measles entry) has many of the same symptoms as scarlet fever. However, a scarlet fever rash looks quite different from a measles rash. Also, scarlet fever is usually accompanied by a sore throat, and measles is not.

Some symptoms of strep throat (see strep throat entry), such as a sore throat and fever, are also similar to those of scarlet fever. But the two diseases are easily distinguished from each other by the appearance of the sandpaper-like rash that is associated with scarlet fever.

A doctor looks for the characteristic rash as well as the "strawberry tongue" (which only appears in children). If questions remain, laboratory tests can be used to make a final determination. Blood tests, for example, can distinguish between a bacterial infection (like scarlet fever) and a viral infection (like strep throat). A throat culture can also be used to do this.

A throat culture consists of a small amount of material taken from the patient's throat. with a cotton swab. The material is then allowed to grow in a warm place overnight before the culture is examined to determine whether the infection is caused by bacteria or a virus.

TREATMENT


Scarlet fever usually clears up on its own within a few days. However, treatment with antibiotics, such as penicillin, may be helpful. Antibiotics are substances derived from bacteria or other organisms that fight the growth of other bacteria or organisms. Antibiotics can reduce the severity of the symptoms, prevent complications, and prevent spreading the disease to others.

Penicillin is the drug of choice for treating scarlet fever. It can be injected or swallowed. For people allergic to penicillin, antibiotics such as erythromycin (pronounced ih-rith-ruh-MIS-in) or clindamycin (pronounced klin-duh-MI-sun) can be used as an alternative. As with all medications, the full course of treatment should be completed even if the patient seems well. Stopping a treatment too soon can result in complications such as rheumatic fever or kidney inflammation.

Bed rest is not necessary with scarlet fever, nor is isolation of the patient. Acetaminophen may be given for fever or relief of pain. Aspirin should not be given to children with fever due to the possibility of developing Reye's syndrome (see Reye's syndrome entry).

PROGNOSIS


Full recovery is expected if the disease is treated promptly with antibiotics. A person who has had scarlet fever can not get the disease again.

PREVENTION


The best method of prevention is to avoid others who have the disease.

FOR MORE INFORMATION


Periodicals

Pellman, Harry. "The Sick Child that Has a Rash." Pediatrics for Parents (July 1995): p. 46.

Web sites

"Scarlet Fever." KidsHealth.org. [Online] http://kidshealth.org/parent/common/scarlet_fever.html (accessed on November 2, 1999).

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Scarlet Fever

Scarlet Fever

A Sore Throat That Gets Worse

Scarlet fever is a bacterial infection that causes a sore throaty rash, and chills.

KEYWORDS

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Rash

Streptococcal infection

The words scarlet fever once struck fear in the hearts of people. The bacteria that cause scarlet fever are easy to spread, and in the 1800s there were epidemics. Children younger than 10 years old were especially at

Poor Beth

H ow dark the days seemed now, how sad and lonely the house, and how heavy were the hearts of the sisters as they worked and waited, while the shadow of death hovered over the once happy home. With these words, author Louisa May Alcott captures the fear and tragedy that scarlet fever spread in the 1800s.

Based on Alcotts own growing-up years, Little Women is the tale of Jo March and her sisters, Meg, Amy, and Beth. Immensely popular since its publication in 1869, it has been made into a movie at least four times. Beth, beloved by family and friends for her sweet nature and musical talent, develops scarlet fever when the girls mother is away caring for their father, who has been injured in the Civil War. This sad part of the story never fails to bring tears to readers and movie audiences.

Scarlet Fever In History

The earliest concise description of scarlet fever and its symptoms was given by the German physiologist Daniel Sennert. In 1619 Sennert accurately observed and recorded the sequence of the diseases symptoms: the appearance of the associated rash, its decline, and scaling of the skin. In the eighteenth century, epidemics of scarlet fever were reported throughout Europe and America. During this time, physicians developed a clear clinical understanding of the disease. The first clinical standards for differentiating scarlet fever from similar diseases were established by Armand Trousseau. In 1887 the English physician Edmund Emmanuel Klein identified scarlet fever as being caused by Streptococcus bacteria that were observed to grow on the tonsils and secrete a rash-producing toxin. The American physician George F. Dick and his wife Gladys R. H. Dick isolated the toxin in the 1920s. After World War II, penicillin became available as an effective means of curing the disease.

risk of death or serious complications, such as rheumatic fever. Scarlet fever also was a mysterious disease, because it would infect only some members of a family and not others. A good example of scarlet fevers effect can be found in the 1869 book Little Women (see sidebar).

Today, scarlet fever is not as deadly, because antibiotics are available to fight the streptococcal bacteria that cause the infection.

A Sore Throat That Gets Worse

Scarlet fever is caused by exposure to someone who is infected with streptococcal bacteria. People with the strep infection can spread it by sneezing or coughing. It also can be spread by sharing drinking glasses or eating utensils with people who are infected.

The first signs of scarlet fever usually start within a week of exposure to the strep bacteria. A sore throat develops, which is known as strep throat. But in some people, the particular kind of strep bacteria, known as Group A Streptococcus, causes a toxic reaction. A skin rash appears within 1 or 2 days of the sore throat. It looks like a sunburn on the neck, chest, and underarms. Less often the rash can appear on the face or the groin. The skin feels rough, like sandpaper. Within a week, the rash usually starts to fade, and flaking and peeling of the skin occur.

Scarlet fever also causes a fever with temperatures over 101 degrees Fahrenheit. Glands around the jaw and neck swell and are painful. Chills, nausea, and vomiting can result.

In rare cases, scarlet fever also can result from a skin infection known as impetigo.

Strep throat and scarlet fever can be serious without treatment from a physician. A doctor who suspects a strep infection will use a cotton swab to get a bit of the bacteria from the throat for laboratory testing to confirm that it is streptococcal bacteria. Treatment with antibiotics for 10 days usually kills the bacteria.

See also

Rheumatic Fever

Strep Throat

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scarlet fever

scarlet fever (skar-lit) n. a highly contagious disease caused by toxin-producing bacteria of the genus Streptococcus. The symptoms include fever, tonsillitis, and a widespread scarlet rash; the tongue is also affected, becoming bright red. Treatment with antibiotics reduces the risk of secondary complications, such as ear and kidney inflammation. Medical name: scarlatina. Compare German measles.

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scarlet fever

scarlet fever (scarlatina) Acute infectious disease, usually affecting children, caused by bacteria in the Streptococcus pyogenes group. It is characterized by a bright red body rash, fever, vomiting and a sore throat. It is treated with antibiotics.

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"scarlet fever." World Encyclopedia. 2005. Encyclopedia.com. 28 Jul. 2016 <http://www.encyclopedia.com>.

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scarlet fever

scar·let fe·ver • n. an infectious bacterial disease affecting esp. children, and causing fever and a scarlet rash. It is caused by streptococci.

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