Scarlet Fever Overview

Scarlet Fever Overview

• Scarlet fever is a bacterial illness, also known as scarlatina
• Characterized by a bright red rash covering most of the body
• Often accompanied by a sore throat and high fever
• Most common in children aged 5 to 15 years old

Learning Objectives

• Identify the causative agent of scarlet fever
• Understand the clinical presentation and complications of the disease
• Recognize the available treatment options

Background

• Scarlet fever develops in some people who have strep throat
• A bright red rash is a key feature that spreads across the body
• Scarlet fever usually comes with a sore throat and high fever
• While once a serious childhood illness, antibiotic treatments have lessened its severity
• Untreated, it can lead to more serious issues, impacting the heart, kidneys, and other organs

Causes

• Caused by streptococcal pyrogenic exotoxins (SPEs) types A, B, and C
• Produced by group A beta-hemolytic streptococci (GABHS)
• Found in secretions and discharges from the nose, ears, throat, and skin
• Spread through droplets expelled when an infected person coughs or sneezes
• Incubation period typically lasts 2 to 4 days

Risk Factors

• Children aged 5 to 15 are more susceptible to scarlet fever
• Transmission is more likely among those in close contact (family members, classmates)

Symptoms

• Red rash: Looks like a sunburn, feels like sandpaper, typically begins on the face/neck and spreads to trunk, arms, and legs; reddened skin turns pale under pressure
• Red lines: Folds of skin around the groin, armpits, elbows, knees, and neck become more deeply red than the surrounding rash
• Flushed face: Face appears flushed with a pale ring around the mouth (circumoral pallor)
• Strawberry tongue: The tongue is red and bumpy, often covered with a white coating

Additional Symptoms

• Fever of 101°F (38.3°C) or higher, possibly with chills
• Very sore and red throat, sometimes with white or yellowish patches
• Difficulty swallowing
• Enlarged, tender lymph nodes in the neck
• Nausea or vomiting
• Headache

How to Spot Scarlet Fever

• Fine red rash, feels like sandpaper
• White coating on tongue that peels after a few days, becoming swollen and red ("strawberry tongue")
• Fever over 38.3°C (101°F)
• Flushed red face, but pale around the mouth
• Swollen glands (lymph nodes) in the neck

Complications

• Rare but possible if bacteria spreads; complications include:
  • Abscesses around tonsils
  • Swollen neck lymph nodes
  • Ear, sinus, and skin infections
  • Pneumonia (lung infection)
  • Rheumatic fever (heart disease)
  • Post-streptococcal glomerulonephritis (kidney disease)
  • Arthritis (joint inflammation)
• Treatment with antibiotics can prevent most complications

Differential Diagnosis

• Includes conditions like Kawasaki disease, toxic shock syndrome, and others (e.g. several viral infections)

Prevention

• There is no vaccine for scarlet fever
• Prevention strategies are the same as standard precautions for infections (e.g., hand hygiene)

Treatment

• Penicillin or amoxicillin are the first-line treatments for those not allergic to penicillin
• Other antibiotics are used for allergic individuals

This quiz provides an overview of scarlet fever, a bacterial illness primarily affecting children. Learn about its causes, symptoms, and available treatments, as well as its clinical implications. Test your knowledge on the key aspects of this disease.