Scarlet fever

Scarlet fever, scarlatina, is a infectious exanthema disease caused by beta-hemolytic group A streptococcus - Streptococcus pyogenes, which most often affects preschool and school children age. It is a streptococcal sore throat with a sore throat rash.

Burn occurs in a child susceptible to a given streptococcal serotype and its pyrogenic exotoxin. The resulting exanthema is the result of an interaction between exotoxin. and antibody me at the capillary level.

Originator
Streptococcus pyogenes – group A beta-hemolytic streptococcusgroup A beta-hemolytic streptococcus;
 * according to the structure of the M protein, it has about 80 serotypes;
 * consists of 3 types of pyrogenic exotoxin (A, B, C) - formerly referred to as burn, ie erythrogenic toxin (functionally superantigen).

Epidemiology

 * Source: patient or exotoxin-producing streptococcal carrier;
 * transmission: droplets;
 * entrance road: nosohltan, but also broken skin ("morning sleep");
 * incidence in the Czech Republic (2000–2009): 3000–4500/year, ie. 28-43 patients per 100 000 population and year.;
 * most often aged 3-10 years;
 * incubation period: 2-5 days.

Clinical picture

 * Streptococcal angina with a spinal rash;
 * fever, vomiting, abdominal pain;
 * rash is mainly in the lower abdomen, groin, inner thighs, armpits and elbows;
 * the skin is rough to the touch ("goosebumps" symptom);
 * in the face is diffuse erythema with circumoral fading ("Filat's symptom");
 * raspberry tongue, on the palate petechiae, edematous uvula;
 * small papules in the area of the nail beds and on the arches ("Šrámek's flag");
 * mild lymphadenopathy of the anterior cervical nodes;
 * currently the course is light:
 * angina is bluetongue, low fever;
 * rash few, lasts a short time;
 * Complications are rare.

Diagnostics

 * Cultivation almond swab;
 * blood count: leukocytosis, left shift, mild eosinophilia;
 * serological evidence of antistreptococcal antibody (ASLO) rise in convalescent serum (antistreptolysin and antideoxyribonuclease).

Differential diagnostics

 * They can cause scarlatiform rash:
 * staphylococci;
 * Arcanebacterium haemolyticum;
 * Corynebakterium ulcerans;
 * Mycoplasma pneumoniae;
 * enteroviruses;
 * adenoviruses;
 * alergies.

Therapy
The drug of choice is  penicillin for at least 10 days, for allergies macrolides, cephalosporins and erythromycin. However, erythromycin resistance is becoming more common.
 * isolation of the patient (in the infection department or at home).

Complication

 * peritonsillar abscess
 * retropharyngeal absces
 * acute glomerulonephritis
 * rheumatic fever

Prevention

 * if present, tonsils are swabbed at contacts → in case of a positive finding of streptococcus A treatment penicillin
 * subject to report

related articles

 * Rod Streptococcus: Streptococcus pyogenes • Streptococcus agalactiae • Streptococcus pneumoniae • Streptococcus mutans • Oral streptococci
 * Streptococcal infections: Group A streptococcal infection • Scarlet fever • Sleep angina • Erysipel • Impetigo • Infections caused by virulent streptococci • Complications and treatment of streptococcal infections • Rheumatic fever

Reference

 * http://www.szu.cz/tema/prevence/spala-manual-iv
 * STATE HEALTH INSTITUTE ,, et al. Selected infectious diseases in the Czech Republic in the years 2000-2009 [online]. © 2010. [feeling. 2010-08-15]. < http://www.szu.cz/publikace/data/vybrane-infekcni-nemoci-v-cr-v-letech-1998-2007-absolutne >.
 * TASKER, Robert C., Robert J. MCCLURE and Carlo L. ACERINI. Oxford Handbook by Pediatrics. 1st edition. New York: Oxford University Press, 2008. pp. 685.  ISBN 978-0-19-856573-4.
 * ROTTENBERG, Jan. Differential diagnosis, therapy and complications of acute tonsillitis [online] . In solen.cz. Spring and summer in the surgery and pharmacy . 1st edition. Olomouc: Solen, 2010. 138 pp. 48-57. Also available from . ISBN 978-80-87327-32-6
 * GOERING, Richard V and Hazel M DOCKRELL. Mims' medical microbiology. 5th edition. Prague: Triton, 2016. 568 pp. 351.  ISBN 978-80-7387-928-0.