What it is? Scarlet fever is called an infectious disease of an acute nature caused by hemolytic streptococcus, which is accompanied by signs of angina, general intoxication and the appearance on the skin of small-scale rash.
Differs high risk of complications. This disease is most often observed in children of preschool or primary school age, the probability of infection is highest between six and twelve years.
Infants suffer scarlet fever rarely, they are protected by the mother's immunity, which they receive during pregnancy and breastfeeding. In adults, such a diagnosis is also detected infrequently. Timely and correct treatment allows you to avoid the occurrence of serious complications and the lethal outcome to which scarlet fever ended before the discovery of antibiotics.
Today, the incidence of the disease and the occurrence of severe forms is reduced.
Causes of scarlet fever in children
In children and adults, the disease causes Streptococcus pyogenes, which belongs to group A of hemolytic streptococci widely represented in modern society. The method of their spread is airborne, although the probability of transmission of the causative agent by the contact-household method is not excluded.
The greatest danger in terms of the possibility of infection is a person who has scarlet fever for the first few days, during this period, the greatest number of pathogens is released. The source of infection can act and a healthy person who is the carrier of the causative agent of scarlet fever.
The most favorable time for the appearance of the disease is the autumn-winter period, a suitable geographic area - countries with a temperate climate.
The pathogenesis of scarlet fever
is characterized by the presence and consistent development of three main lines that are associated with toxic, septic, allergic manifestations of streptococcal infection. They are closely related.
In places through which streptococcus was introduced into the body( and this is most often mucous or areas of damage to the skin by burns or wounds), a foci of inflammation forms. In case of scarlet fever, pathogenic bacteria are located on the palatine tonsils. The causative agent can freely move through the body through the lymphatic pathways, coming into contact with nearby tissues or intrakanalykulyarno.
A toxic substance of hemolytic streptococcus appears in the blood, which has a negative effect on the activity of the nervous, cardiovascular and endocrine systems. The development of a complex pathological process, represented by toxic, septic and allergic syndromes, begins.
The thermolabile exotoxin fraction affects the development of the toxic pathogenesis line, which explains the fever, intoxication, sympathetic manifestations of vascular changes. With a complicated course of the disease, hypodynamic disorders, hemorrhagic syndrome, may appear.
The microbial factors of BGCA affect the appearance of the septic line. It is characterized by the appearance of purulent and necrotic changes in inflammation in the areas of primary infection. This line may be leading in the symptoms of the onset of the disease or arise as a complication in its later stages.
Because of the increased reactive sensitivity of damaged tissues, an allergic line appears. Symptoms of allergies may appear from the onset of the disease, but most worrisome after 2 weeks after infection, in the form of complications such as rashes, unmotivated subfebrile, myocarditis, arthritis, lymphadenitis, and similar ailments.
In the case of scarlet fever, the phases of the vegetative nervous activity consistently replace each other: the increased tone of the sympathetic department, characteristic for the initial stage of the disease, is replaced in the second week by the tone of the parasympathetic department.
Symptoms of scarlet fever in children
In adults and children, the duration of the incubation period can vary from one day to ten, then the symptoms appear. Scarlet fever usually manifests itself as a sharp increase in body temperature, the condition is aggravated by headaches, general malaise, signs of weakness, tachycardia, abdominal tenderness. Vomiting may occur due to intoxication.
Swallowing becomes painful, the examination reveals the so-called flaming zoe( hyperemia of the arch, tongue, tonsils and the entire posterior part of the pharynx, limited by a line separating the mucous and hard palate).There is a possibility of formation of follicular lacunar angina, in which small or deeper foci of raids occur on the affected tonsils.
The first specific symptoms of scarlet fever in children give out a whitish bloom on the tongue. On day 4-5 the organ surface is cleaned and acquires a red-crimson color, the papillae have a hypertrophic appearance. In severe forms of the disease, the lips are also colored in a crimson tint.
The peculiarity of scarlet fever is its location on the hyperemic area and occurrence in the first couple of days of the disease. A small-scale rash appears on the face and upper segment of the trunk, gradually spreading on the limb fold lines, the inner regions of the thighs and sides.
An important symptom of scarlet fever is the formation of special strips of dark red in the skin folds. In some areas, rash manifestations can merge into continuous erythema. On the surface of the face the rash occupies the cheeks, less pronounced on the temples and forehead, while the nasolabial triangle remains free from it and stands out against the general background with a special pallor. If the affected area is pressed, the rash will disappear for a while.
Due to the increased fragility of the vessels at the site of articular folds and in areas where the skin is squashed or rubbed with clothing, minor pinpoint hemorrhages may occur.
Sometimes the flow of scarlet fever is not limited to rash, in this case the disease is accompanied by small vesicles and maculopapular elements. Manifestations of rash may be completely absent or appear only on the fourth day of the disease.
Treatment for scarlet fever
Treatment for the elimination of infection is most often done at home. Only severe cases of scarlet fever, the appearance of its complications, or the joint residence of a patient with young children who have not had this disease before, are the reason for the appointment of inpatient treatment.
For prophylactic purposes, the patient is isolated for up to 10 days after the onset of the disease. Children can be sent to institutions of preschool and school education only 12 days after recovery.
The patient is assigned a ten-day bed rest. At this time, it is recommended to maintain a sparing diet with the feeding of cooked and wiped semi-liquid warm dishes. To accelerate the elimination of toxins, intensive drinking is prescribed. After the acute period of the disease, a gradual transition to the usual menu begins.
Various manifestations of scarlet fever are treated with the following tools:
1) To eliminate the root cause of the disease, prescribe narrow-spectrum drugs of choice, in particular, prefer penicillin, as well as its analogues. The second group includes erythromycin and cefazolin. If these funds are not suitable, resort to a wide-ranging group of antibiotics, cephalosporins. Usually prescribed treatment with penicillin - course for 10 days.
2) For local treatment use yoks, stopangin, hexoral and others. Their choice depends on the age characteristics of the patient and the clinical picture of the disease. This includes local measures such as gargling chamomile, furacilin or rotocaine in a dissolved form.
3) To carry out anti-inflammatory and immunotropic therapy prescribed lysobact or an immunon.
4) Suprastin, zirtec, tavegil, etc. are used to exert antitoxic effects.
5) If complications arise, antitussive or antipyretic drugs may be used( giving aspirin to children is prohibited).
All medicines are prescribed by a doctor.
Video: "Treatment of scarlet fever in children - Dr. Komarovsky"
Forecasting the treatment of scarlet fever
With timely and correct treatment on the third day of the disease, the patient begins to feel better, the temperature is gradually returning to normal.
At the end of the first week of the disease, the appearance of the rash pale and disappear, giving way to peeling of the skin. If the treatment course was completed completely, the threat of recurrence of the disease is very small. Life-long immunity is produced, which reliably protects against relapses.
Complications of scarlet fever
In some cases, scarlet fever can provoke the appearance of new diseases. During the first week of illness, the spread of infection from the tonsils to nearby areas is fraught with otitis media, sinusitis, and lymphadenitis.
To rare types of complications include bronchopneumonia, osteomyelitis, mastoiditis and sepsis.
Complex treatment cures these diseases. The greater danger is presented by those complications of scarlet fever, which appear later, they can be expressed by rheumatism, chorea, glomerulonephritis.
Prevention
Preventative measures to prevent disease in children and adults are aimed at the timely identification and isolation of infected people, strengthening the body and immunity. Persons who come into contact with the infected should use sterile masks and follow personal hygiene.
From the onset of infection and until discharge from hospital, it takes up to two weeks, after which it is necessary to stay at home for the same amount of time. You can begin a full-fledged way of life not earlier than in 3 weeks, at the same time it is necessary to pass appropriate tests for the presence of Streptococcus pyogenes.
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