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. [1] 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.;[2]
  • most often aged 3-10 years;
  • incubation period: 2-5 days.

Clinical picture

Raspberry tongue
  • Streptococcal angina with a spinal rash;
  • fever, vomiting, abdominal pain;[3]
  • 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;[3]
  • small papules in the area of the nail beds and on the arches ("Šrámek's flag");[4]
  • mild lymphadenopathy of the anterior cervical nodes;[3]
  • 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

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.<ref name="Goering2">

  • isolation of the patient (in the infection department or at home).

Complication

Prevention

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


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 <www.solen.cz>. 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 .
  1. ↑ http://www.szu.cz/tema/prevence/spala-manual-iv
  2. ↑
  3. ↑ a b c d
  4. ↑