Scarlet fever is an infectious disease: symptoms, causes, treatment and prevention

Scarlet fever is an acute infectious disease, known since the Middle Ages. Its name comes from the English phrase scarlet fever, which means "scarlet fever." So called the disease due to the characteristic red rash on the skin. Today, this ailment is not too widespread. However, we must remember that scarlet fever often occurs with severe symptoms. This disease is highly contagious. Outbreaks of scarlet fever in kindergartens or schools are periodically noted. Usually, the incidence increases in winter, in summer, children get sick much less often. During the incubation period, the child may not feel any unpleasant symptoms, but it becomes a source of infection for others.

Causative agent of the disease

Scarlet fever is a disease that is caused by group A streptococcus. Once inside a person, this microorganism affects the nasopharynx, which leads to sore throat. In addition, streptococcus produces toxic substances that poison the body. Due to the effects of microbial poisons, a person develops a rash (exanthema), worsens, nausea, headache. These are signs of general intoxication of the body.

Group A streptococcus causes a person not only scarlet fever, but also other infectious diseases, such as tonsillitis, streptoderma, rheumatism, nasopharyngitis. All these ailments occur with symptoms of general intoxication and often with rashes.

Transmission routes

The cause of scarlet fever is always the penetration of group A streptococcus into the body, and the infected person becomes a source of infection. The patient begins to pose a danger to his surroundings about 1 day before the onset of exanthema (rash) and other first symptoms. 3 weeks after the onset of manifestations of the pathology, the patient ceases to be infectious.

An infection can pass from a sick person to a healthy person in the following ways:

1. Airborne. In this way, patients become infected most often. With prolonged communication with the patient, streptococci enter the body through the nose and throat. An infected person releases microorganisms during breathing, sneezing, and coughing.
2. Food (alimentary). In this case, streptococcus is transmitted through food and unwashed dishes.
3. Contact. Infection occurs through dirty hands and household items that the patient touched.
4. Through damage to the skin. This is a fairly rare way of infection. If streptococcus enters the body through wounds and scratches, then scarlet fever occurs without sore throat.

It often happens that a person becomes infected, even without ever having contact with patients with scarlet fever. Where does the infection come from? The patient may get the disease by contact with people suffering from tonsillitis or nasopharyngitis, if these ailments were caused by group A streptococcus. However, in this case, the pathology will proceed in a special form. Only the throat is affected, without pronounced signs of general intoxication.

Some people are asymptomatic carriers of streptococcal infection. They can also become a source of infection.

Usually, factors such as hypothermia, a decrease in the body's defenses, frequent colds and chronic throat diseases contribute to infection. The disease affects adults with diabetes and adrenal gland pathology. It can also be noted that group A streptococcus often infects children with diathesis and low weight. After suffering scarlet fever in a person, lifelong immunity is established. It is impossible to get infected with this disease again. Scarlet fever in adults is a fairly rare occurrence. More often this disease infects children.

Stages of the disease

Several stages of scarlet fever can be distinguished:

• incubation period;
• acute period;
• stage of the disappearance of symptoms and recovery.

During the incubation period, it is impossible to notice deviations in the well-being of a person. As a rule, no symptoms are observed at this time. Usually the disease begins acutely, the patient's condition rapidly worsens.

Incubation period

The incubation period of scarlet fever is from 1 to 10 days. But most often, the disease proceeds hidden within 2-4 days after infection. The well-being of the person still remains normal. But streptococcus already begins to negatively affect the body.

In the incubation period of scarlet fever, the pathogen is fixed at the injection site: on the mucous membranes of the respiratory system or on the skin. Then streptococcus enters the bloodstream and lymph vessels and spreads throughout the body. After this, the acute stage of the disease begins.

Symptoms of the acute stage

The onset of symptoms of scarlet fever begins with a deterioration in overall well-being. The patient has a headache, as with migraines, weakness and fever. The temperature can rise to 39-40 degrees. Due to the poisoning of the body with streptococcal toxins, nausea and vomiting occur.

One of the main signs of scarlet fever is a throat lesion. It becomes painful to swallow. The tonsils, the back of the pharynx, tongue and arch acquire a bright red color. In some cases, a purulent coating forms on the throat, it has a white or yellow color. Symptoms of a respiratory tract lesion are similar to a sore throat, but hyperemia and sore throat with scarlet fever are more pronounced.

Lymph nodes increase. On examination, you may notice painful bumps under the jaw, on the neck and behind the ears. In the early days of the disease, the tongue is covered with white or grayish deposits. After 4 - 5 days, it becomes clean, but acquires a crimson color. In severe forms of the disease, hyperemia is noted not only in the tongue, but also in the lips. When listening to the heart with a phonendoscope, tachycardia is determined, but blood pressure remains within normal limits.

Sometimes in the early days of a patient’s illness, abdominal pain is a concern. In such cases, it is necessary to conduct a differential diagnosis of scarlet fever and appendicitis.

An important sign of scarlet fever is a rash. It is necessary to pay attention to the nature of exanthema, this will help to separate streptococcal infection from other pathologies (measles, chickenpox). Rashes usually appear on the first or second day of the disease. The rash with scarlet fever has its own characteristics. It has the appearance of small dots of red color. The size of the spots is not more than 2 mm.

In the early days of the disease, exanthema appears on the face, in the upper body and on the neck. Subsequently, red dots extend to the abdomen, limbs, armpits and buttocks. A characteristic symptom of scarlet fever is a sharp contrast between areas with a rash and healthy skin. This is especially noticeable on the face. Red spots cover the cheeks, the skin looks a little swollen, while the area around the nose and lips usually remains free of rashes. Doctors call this symptom "Filatov's symptom."

With scarlet fever in children, rashes can take the form of pustules filled with liquid contents (vesicles). For this reason, the disease is often confused with chickenpox. The child may be disturbed by itching in the affected areas. However, this is not a characteristic feature. The rash with scarlet fever is not always accompanied by itching, in contrast to chickenpox and herpes infection.

Stage of recovery

On the 4th-5th day of the disease, the rash turns pale, and then completely disappears. After this, the patient has peeling of the skin in the affected areas for 2 weeks. On the palms and feet of the epidermis can come in large layers. From day 5, the temperature usually decreases. The general condition is gradually improving.

However, during this period there is a risk of complications of scarlet fever. In the second week of the disease, streptococcus can affect the kidneys, heart and joints. Therefore, despite the improvement in the patient’s well-being, treatment must be continued and carried through to the end.

Forms of the disease

In medicine, it is customary to classify this disease by severity and with the passage. Scarlet fever can occur in mild, moderate and severe forms. They are characterized by the following features:

1. Light form. Intoxication is weak, the temperature is increased to +38 degrees. The patient’s health is practically not impaired. There is a slight sore throat and pale pink spots on the skin. This form of the disease is dangerous for others, since the patient’s condition is slightly changed, a person can contact with other people and be a source of infection.
2. Moderate form. The disease begins acutely, the temperature rises to +39 degrees. A sore throat is pronounced, a bright red rash in the form of dots is noticeable, lymph nodes are enlarged, and well-being worsens.
3. Severe form. It proceeds with a predominance of signs of intoxication or septic lesions of the body. In some cases, the symptoms combine (toxic-septic form). Currently, this type of scarlet fever is very rare. This is due to the use of penicillin antibiotics, which can affect streptococcus in the first hours of the disease.

The severe form of scarlet fever, in turn, is divided into three types:

1. Toxic form. This type of scarlet fever develops in children up to 7-10 years old. The temperature rises to +40 degrees, there is delirium. Vomiting with diarrhea may appear. The mucous membranes of the throat turn bright red. The general condition sharply worsens: the pulse becomes weak, blood pressure drops, vascular insufficiency develops. The rash is small, may have a bluish color with hemorrhages. In some cases, the effects of intoxication are growing rapidly (fulminant form), and the patient may die on the 1st day of illness.
2. Septic form. With this type of scarlet fever, deterioration in well-being increases over several days. The temperature rises to +40 degrees. Symptoms of intoxication are mild, signs of inflammation predominate. Streptococcus quickly penetrates from the throat to other organs. Secondary foci of inflammation occur: in the maxillary sinuses, temporal bone, middle ear. White blood cells and ESR are sharply increased in the blood. A patient may die from sepsis in the first week of illness.
3. Toxic septic form. It is characterized by a combination of toxic and septic symptoms. In the early days of the disease, intoxication phenomena predominate, and then the symptoms of inflammation join them.

Sometimes scarlet fever can occur in atypical forms, in which there is no classical picture of the disease. In such cases, sore throat and rash are weak and it is sometimes difficult to diagnose the pathology. The following atypical types of the disease are distinguished:

1. Erased form. The temperature is slightly increased, the rash may be completely absent. There is a slight inflammation in the throat, as with SARS, the lymph nodes are not enlarged. Scarlet fever in adults occurs in this form quite often.
2. Extra buccal scarlet fever. Occurs when infection is transmitted through skin lesions. No sore throat. Patients complain of slight weakness. A rash occurs around a wound or cut at the site of streptococcus entry.
3. Hemorrhagic scarlet fever. This is a serious and dangerous form of the disease. The general condition worsens at lightning speed, and often a fatal outcome occurs even before the occurrence of specific manifestations of scarlet fever. There is a severe headache with vomiting, hemorrhages in various organs, convulsions. Patients die on the background of collapse and a critical drop in blood pressure.

Hemorrhagic and extra buccal types of the disease are extremely rare. The erased form represents an epidemiological danger, since the patient can spread the infection without even knowing that he is sick.

Possible complications

Early complications of scarlet fever are associated with the effects of streptococcus on the organs. These include:

1. Inflammation and swollen lymph nodes. This symptom always accompanies scarlet fever. However, if the nodes are enlarged excessively, reach the size of an egg and make it difficult to chew and swallow, then this is not a manifestation of the disease, but a complication. In severe cases, adenoflegmon may occur - a purulent inflammatory process in the subcutaneous tissue. This is also a complication caused by damage to the lymph nodes.
2. The formation of secondary purulent foci in other organs. Most often, streptococcus affects the kidneys and liver. Such a complication is observed in children with severe forms of scarlet fever.
3. Secondary inflammatory processes in the middle ear (otitis media), maxillary sinus (sinusitis), pharynx (nasopharyngitis). They occur as a result of the spread of infection from the throat to nearby organs.
4. Hemorrhage. Occur due to the effects of toxins on blood vessels. Patients develop nosebleeds or a hemorrhagic rash.
5. Damage to the toxins of the heart and kidneys. Such complications are manifested by pathological changes in the walls and chambers of the heart, bradycardia and a decrease in blood pressure. Damage to the kidneys leads to rare urination, up to anuria (complete absence of urine formation).

Often there are late effects of scarlet fever. These are pathologies of autoimmune origin associated with the destruction of body tissues by their own antibodies. Most often, after recovering from scarlet fever, patients have the following diseases:

1. Rheumatism. Joint lesions are observed approximately 2-3 weeks after recovery. Pathology often goes away on its own, but can flow into a chronic form.
2. Glomerulonephritis. This kidney disease is a common consequence of scarlet fever. Patients have swelling of the face and body, lower back pain, high blood pressure. Without treatment, the disease is prone to chronicity.
3. The defeat of the heart. Pathological changes in the heart valves (mitral and aortic) are noted. This is also associated with autoimmune processes and the formation of antibodies. Such a pathology needs treatment (sometimes even surgical), since it does not disappear on its own and becomes chronic without therapy.

Diagnostic Methods

According to its symptoms, scarlet fever resembles many other infectious diseases, accompanied by rashes. Therefore, it is important to conduct differential diagnosis with allergic manifestations, rubella, chickenpox, dermatitis, measles, pseudotuberculosis.

The specialist makes a preliminary diagnosis during the examination of the patient and the collection of anamnesis. If you put a palm on the patient’s skin, the rash usually disappears. This is a specific sign of the disease. The doctor draws attention to the acute onset of the disease, the nature of the rashes, signs of sore throat. To clarify the diagnosis, the following examinations are prescribed:

• general blood analysis;
• throat swab with bacosow;
• analysis for antibodies to streptococcus A;
• analysis for a specific antigen - streptolysin O;
• electrocardiogram.

These studies help distinguish scarlet fever from other infectious rash pathologies.

How to treat a disease

In the treatment of scarlet fever, antibiotics of the penicillin group are used. The following drugs are prescribed:

• "Benzylpenicillin";
• "Phenoxymethylpenicillin."

If the patient is allergic to penicillin medications, then apply "Azithromycin", "Erythromycin", "Clarithromycin".

With scarlet fever, it is recommended to observe bed rest for at least 10 days. During the acute period, mechanically sparing food should be consumed, as swallowing can be painful. Drinking more fluids is recommended to remove toxic substances from the body. In addition to antibiotic therapy, symptomatic treatment of scarlet fever is performed. It is recommended to gargle with herbal decoctions and disinfectant solutions, take ascorbic acid to strengthen the immune system. Antihistamines are also prescribed to prevent allergic reactions. If necessary, physiotherapy is performed on the throat (quartz, UHF).

3 weeks after the onset of the disease, it is necessary to undergo an examination by a cardiologist and a rheumatologist in order to identify possible complications to the joints and heart in time.

Infection prevention

Specific prophylaxis of scarlet fever has not been developed. The spread of the disease can only be prevented by restricting contact with sick people. To do this, the following measures are taken:

1. If it is not possible to isolate the patient from children from 3 months to 10 years, then he will be hospitalized in a hospital for epidemiological reasons.
2. For children who were in contact with the patient, medical supervision is established for a period of 7 to 17 days.
3. Having been ill with scarlet fever, they are discharged to work, study or in a preschool institution not earlier than 10-12 days from the onset of the first symptoms. In this case, the absence of signs of sore throat, rashes, and blood and urine values ​​should be within normal limits.

Such prevention of scarlet fever will help minimize the risk of infection.

Often parents are interested in: is it possible to vaccinate children against this disease? There is currently no special vaccination. However, several decades ago such a vaccine existed. , . , . 1980 .

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