Scarlet Fever PDF

Scarlet fever By Dr.Elaf Yousif Beram M.B.CH.B, F.I.M.S/ FM Learning Objectives: 1. To know the causative agent of scarlet fever. 2. To know the clinical presentation and complication of disease. 3. To know the available treatment for that disease. Background: Scarlet fever is...

Scarlet fever By Dr.Elaf Yousif Beram M.B.CH.B, F.I.M.S/ FM Learning Objectives: 1. To know the causative agent of scarlet fever. 2. To know the clinical presentation and complication of disease. 3. To know the available treatment for that disease. Background: Scarlet fever is a bacterial illness that develops in some people who have strep throat. Also known as scarlatina, scarlet fever features a bright red rash that covers most of the body. Scarlet fever is almost always accompanied by a sore throat and a high fever. Scarlet fever is most common in children 5 to 15 years of age. Although scarlet fever was considered a serious childhood illness, antibiotic treatments have made it less threatening. Still, if left untreated, scarlet fever can result in more-serious conditions that affect the heart, kidneys and other parts of the body. Causes: It is caused by streptococcal pyrogenic exotoxins (SPEs) types A, B, and C produced by group A beta-hemolytic streptococci (GABHS) found in secretions and discharge from the nose, ears, throat, and skin. The infection spreads from person to person via droplets expelled when an infected person coughs or sneezes. The incubation period is usually two to four days. Risk factors: Children 5 to 15 years of age are more likely than are other people to get scarlet fever. Scarlet fever germs spread more easily among people in close contact, such as family members or classmates. Symptoms: The signs and symptoms that give scarlet fever its name include: Red rash: The rash looks like a sunburn and feels like sandpaper. It typically begins on the face or neck and spreads to the trunk, arms and legs. If pressure is applied to the reddened skin, it will turn pale. Red lines: The folds of skin around the groin, armpits, elbows, knees and neck usually become a deeper red than the surrounding rash. Flushed face: The face may appear flushed with a pale ring around the mouth so called circumorally pallor. Strawberry tongue: The tongue generally looks red and bumpy, and it's often covered with a white coating early in the disease.  The rash and the redness in the face and tongue usually last about a week. After these signs and symptoms have subsided, the skin affected by the rash often peels. Other signs and symptoms associated with scarlet fever include: Fever of 101 F (38.3 C) or higher, often with chills Very sore and red throat, sometimes with white or yellowish patches Difficulty swallowing Enlarged glands in the neck (lymph nodes) that are tender to the touch Nausea or vomiting Headache Differential diagnosis : Includes: 1. Kawasaki disease. 2. toxic shock syndrome (TSS). 3. staphylococcal scalded skin syndrome (SSSS). 4. rubella, rubeola, mononucleosis, fifth disease, acute lupus erythematosis, juvenile arthritis, other viral exanthems. 5. drug reactions. Complications: Complications are rare but can occur after having scarlet fever. This can happen if the bacteria spread to other parts of the body. Complications can include: 1. Abscesses (pockets of pus) around the tonsils. 2. Swollen lymph nodes in the neck. 3. Ear, sinus, and skin infections. 4. Pneumonia (lung infection). 5. Rheumatic fever (a heart disease). 6. Post-streptococcal glomerulonephritis (a kidney disease). 7. Arthritis (joint inflammation). Treatment with antibiotics can prevent most of these health problems Prevention: There is no vaccine to prevent scarlet fever. The best prevention strategies for scarlet fever are the same as the standard precautions against infections. Treatment: Either penicillin or amoxicillin are recommended as a first choice for people who are not allergic to penicillin. Other antibiotics to treat scarlet fever in people who are allergic to penicillin. Summary: Scarlet fever is a bacterial illness also known as scarlatina, scarlet fever features a bright red rash that covers most of the body. Scarlet fever is almost always accompanied by a sore throat and a high fever.  Case scenario: A boy of 9 years and 10 months entered the infectious department on the 5th day of his disease. On admission he complained of sore throat, rash, and malaise; he refused to eat and drink. Present history: the disease had started 5 days earlier with high grade fever, up to 40 °С. The next day, he was examined by a family doctor and an acute tonsillitis was diagnosed. acetaminophen was given. The patient was febrile for 4 days. A pin-point rash appeared on the lower extremities and in the inguinal skin folds on the 4th day. The next day, the rash spread all over the body and changed its appearance, the temperature became normal; but he was very weak, thus he was hospitalized. Past history: the boy was the 4th child in his family and was a patient with Down syndrome. On admission: the patient’s general condition was severe. He was conscious, but crying, afraid of examination. Vital signs: heart rate 96 bmp, respiratory rate 28 per minute, blood pressure 110/60 mmHg. The skin was dry, edematous on the trunk. Facial erythema with perioral pallor, hyperemia of the neck, trunk and limbs. 1.What is the Dx ? 2. what is the causative agent? 3. what is the treatment? THANK YOU