scarlet fever

scarlatina,

an acute, communicable infection, caused by group A hemolytic streptococcal bacteria (see streptococcusstreptococcus
, any of a group of gram-positive bacteria, genus Streptococcus, some of which cause disease. Streptococci are spherical and divide by fission, but they remain attached and so grow in beadlike chains.
..... Click the link for more information. ) that produce an erythrogenic toxin. The disease is now uncommon, probably because antibiotic therapy has lessened the likelihood of spread. It occurs in young children, usually between two and eight years of age, and is spread by droplet spray from carriers and from individuals who have contracted the disease. The incubation period is from three to five days, and infectivity lasts about two weeks. Scarlet fever may be mild or severe, but it is rarely fatal if treated. Typical symptoms are sore throat, headache, fever, flushed face with a ring of pallor about the mouth, red spots in the mouth, coated tongue with raw beefy appearance and inflamed papillae underneath it (strawberry tongue), and a characteristic rough red rash on the skin. The streptococcal bacterium that causes scarlet fever is identical to the streptococcal pharyngitis (strep throat) organism, the difference being the production of a toxin to which the patient is susceptible in the case of scarlet fever. Severe infections are occasionally complicated by rheumatic fever, kidney disease, ear infection, pneumonia, meningitis, or encephalitis. Mild scarlet fever requires only bed rest, antibiotics, analgesics or antipyretics, and symptomatic treatment. Antibiotics, immune serum, and antitoxin may be required for severe cases.

Scarlet fever

An acute contagious disease that results from infection with Streptococcus pyogenes (group A streptococci). It most often accompanies pharyngeal (throat) infections with this organism but is occasionally associated with wound infection or septicemia. Scarlet fever is characterized by the appearance, about 2 days after development of pharyngitis, of a red rash that blanches under pressure and has a sandpaper texture. Usually the rash appears first on the trunk and neck and spreads to the extremities. The rash fades after a week, with desquamation, or peeling, generally occurring during convalescence. The disease is usually self-limiting, although severe forms are occasionally seen with high fever and systemic toxicity. Appropriate antibiotic therapy is recommended to prevent the onset in susceptible individuals of rheumatic fever and rheumatic heart disease. See Medical bacteriology, Rheumatic fever, Streptococcus

Scarlet Fever

an acute infectious disease occurring mainly in childhood and manifested by fever, sore throat, and a rash. The first clinical description of scarlet fever was given in the 17th century by T. Sydenham, who also gave the disease its name.

The causative agent of scarlet fever is a β-hemolytic streptococcus, which belongs to Group A and forms a toxin. The infection is transmitted by infected persons or by carriers. It is mainly airborne, but occasionally occurs through contact with an infected person’s belongings. Scarlet fever is mainly a disease of children up to the age of six or seven. Its incidence increases in the autumn and winter months, and periodic rises in incidence are noted every four to six years. Persons who have recovered from the disease develop specific immunity, with relapse occurring in 1.5–4 percent of the cases. Immunity is determined by observing the skin’s reaction to an inoculated toxin (the Dick test).

The incubation period of scarlet fever averages two to seven days. The onset of the disease is acute and is marked by fever, lethargy, malaise, vomiting, and sore throat. The mucosa of the throat becomes bright red, and spots sometimes appear on the palatine tonsils. The superficial cervical lymph nodes swell and become painful. On the first or occasionally the second day of the disease, a bright-pink or red punctate rash appears on the entire body. The tongue acquires a grayish white coating, which disappears by the fourth or fifth day of the disease; the tongue then becomes bright red and granular (raspberry tongue). The disease continues for three to six more days. After the rash disappears, large portions of the skin peel off.

Scarlet fever may be mild, moderately severe, or severe. The severe form may be toxic, with pronounced symptoms of toxic affection of the nervous and cardiovascular systems.

It may also be septic, with severe inflammation of the throat and a tendency to develop suppurative foci. When the severe form is toxicoseptic, both sets of symptoms are combined. The mild form of the disease predominates, and complications, which are observed in the severe form, seldom occur. Such complications include purulent cervical lymphadenitis, otitis, inflammation of the accessory cavities of the nose and joints, affection of the heart, nephritis, and sepsis. With modern methods of treatment, fatality has been reduced to tenths or hundredths of 1 percent. A very mild form of the disease, lacking in many of the symptoms, is often observed.

Scarlet fever is treated with antibiotics; the toxic form is treated with antitoxic scarlet-fever serum. Various therapeutic means are used to treat complications. Infected persons are isolated for at least ten days; with severe forms of the disease or when living conditions are unfavorable, children are hospitalized. Preschoolers and pupils in the first two grades are permitted to return to school 12 days after the end of the isolation period. Healthy children who have been in contact with infected persons are quarantined for seven days. The premises occupied by infected persons are subjected to regular disinfection.

REFERENCE

Nosov, S. D. Detskie infektsionnye bolezni, 4th ed. Moscow, 1973.

S. D. NOSOV

scarlet fever

[′skär·lət ′fē·vər] (medicine) An acute, contagious bacterial disease caused by Streptococcus hemolyticus; characterized by a papular, or rough, bright-red rash over the body, with fever, sore throat, headache, and vomiting occurring 2-3 days after contact with a carrier.

scarlet fever

an acute communicable disease characterized by fever, strawberry-coloured tongue, and a typical rash starting on the neck and chest and spreading to the abdomen and limbs, caused by all group A haemolytic Streptococcus bacteria

scarlet fever

Scarlet Fever

Definition

Scarlet fever is an infection that is caused by a bacteria called streptococcus. The disease is characterized by a sore throat, fever, and a sandpaper-like rash on reddened skin. It is primarily a childhood disease. If scarlet fever is untreated, serious complications such as rheumatic fever (a heart disease) or kidney inflammation (glomerulonephritis) can develop.

Description

Scarlet fever, also known as scarlatina, gets its name from the fact that the patient's skin, especially on the cheeks, is flushed. A sore throat and raised rash over much of the body are accompanied by fever and sluggishness (lethargy). The fever usually subsides within a few days and recovery is complete by two weeks. After the fever is gone, the skin on the face and body flakes; the skin on the palms of the hands and soles of the feet peels more dramatically.This disease primarily affects children ages two to ten. It is highly contagious and is spread by sneezing, coughing, or direct contact. The incubation period is three to five days, with symptoms usually beginning on the second day of the disease, and lasting from four to ten days.Early in the twentieth century, severe scarlet fever epidemics were common. Today, the disease is rare. Although this decline is due in part to the availability of antibiotics, that is not the entire reason since the decline began before the widespread use of antibiotics. One theory is that the strain of bacteria that causes scarlet fever has become weaker with time.

Causes and symptoms

Scarlet fever is caused by Group A streptococcal bacteria (S. pyogenes). Group A streptococci can be highly toxic microbes that can cause strep throat, wound or skin infections, pneumonia, and serious kidney infections, as well as scarlet fever. The Group A streptococci are; hemolytic bacteria, which means that the bacteria have the ability to lyse or break red blood cells. The strain of streptococcus that causes scarlet fever is slightly different from the strain that causes most strep throats. The scarlet fever strain of bacteria produces a toxin, called an erythrogenic toxin. This toxin is what causes the skin to flush.The main symptoms and signs of scarlet fever are fever, lethargy, sore throat, and a bumpy rash that blanches under pressure. The rash appears first on the upper chest and spreads to the neck, abdomen, legs, arms, and in folds of skin such as under the arm or groin. In scarlet fever, the skin around the mouth tends to be pale, while the cheeks are flushed. The patient usually has a "strawberry tongue," in which inflamed bumps on the tongue rise above a bright red coating. Finally, dark red lines (called Pastia's lines) may appear in the creases of skin folds.

Diagnosis

Cases of scarlet fever are usually diagnosed and treated by pediatricians or family medicine practitioners. The chief diagnostic signs of scarlet fever are the characteristic rash, which spares the palms and soles of the feet, and the presence of a strawberry tongue in children. Strawberry tongue is rarely seen in adults.The doctor will take note of the signs and symptoms to eliminate the possibility of other diseases. Scarlet fever can be distinguished from measles, a viral infection that is also associated with a fever and rash, by the quality of the rash, the presence of a sore throat in scarlet fever, and the absence of the severe eye inflammation and severe runny nose that usually accompany measles.The doctor will also distinguish between a strep throat, a viral infection of the throat, and scarlet fever. With a strep infection, the throat is sore and appears beefy and red. White spots appear on the tonsils. Lymph nodes under the jawline may swell and become tender. However, none of these symptoms are specific for strep throat and may also occur with a viral infection. Other signs are more characteristic of bacterial infections. For example, inflammation of the lymph nodes in the neck is typical in strep infections, but not viral infections. On the other hand, cough, laryngitis, and stuffy nose tend to be associated with viral infections rather than strep infections. The main feature that distinguishes scarlet fever from a mere strep throat is the presence of the sandpaper-red rash.Laboratory tests are needed to make a definitive diagnosis of a strep infection and to distinguish a strep throat from a viral sore throat. One test that can be performed is a blood cell count. Bacterial infections are associated with an elevated white blood cell count. In viral infections, the white blood cell count is generally below normal.A throat culture can distinguish between a strep infection and a viral infection. A throat swab from the infected person is brushed over a nutrient gel (a sheep blood agar plate) and incubated overnight to detect the presence of hemolytic bacteria. In a positive culture, a clear zone will appear in the gel surrounding the bacterium, indicating that a strep infection is present.

Treatment

Although scarlet fever will often clear up spontaneously within a few days, antibiotic treatment with either oral or injectable penicillin is usually recommended to reduce the severity of symptoms, prevent complications, and prevent spread to others. Antibiotic treatment will shorten the course of the illness in small children but may not do so in adolescents or adults. Nevertheless, treatment with antibiotics is important to prevent complications.Since penicillin injections are painful, oral penicillin may be preferable. If the patient is unable to tolerate penicillin, alternative antibiotics such as erythromycin or clindamycin may be used. However, the entire course of antibiotics, usually 10 days, will need to be followed for the therapy to be effective. Because symptoms subside quickly, there is a temptation to stop therapy prematurely. It is important to take all of the pills in order to kill the bacteria. Not completing the course of therapy increases the risk of developing rheumatic fever and kidney inflammation.If the patient is considered too unreliable to take all of the pills or is unable to take oral medication, daily injections of procaine penicillin can be given in the hip or thigh muscle. Procaine is an anesthetic that makes the injections less painful.Bed rest is not necessary, nor is isolation of the patient. Aspirin or Tylenol (acetaminophen) may be given for fever or relief of pain.

Prognosis

If treated promptly with antibiotics, full recovery is expected. Once a patient has had scarlet fever, they develop immunity and cannot develop it again.

Prevention

Avoiding exposure to children who have the disease will help prevent the spread of scarlet fever.

Resources

Books

Bennett, J. Claude, and Fred Plum, editors. Cecil Textbook of Medicine. Philadelphia: W. B. Saunders Co., 1996.

scarlet fever

an acute contagious childhood disease caused by Group A beta-hemolytic streptococci or occasionally other serotypes of beta-hemolytic streptococci. It usually affects the pharynx but may also affect the skin (wound and burn scarlet fever) or the birth canal (puerperal scarlet fever). The disease is most common in late winter and spring. Called also scarlatina.

Scarlet fever is usually spread by droplet infection. Objects the infected person has used, such as clothes, dishes, or toys, may carry the streptococcus, but this mode of transmission is rare. Occasionally a widespread outbreak may be caused by milk or food that has been infected by a person carrying the streptococcus. It was formerly a very common and serious disease, but in recent decades the number and severity of cases have greatly decreased. Complications are much less common, largely as a result of the development and use of antibiotics.Symptoms. The incubation period is usually 2 to 5 days, although it may be as few as 1 or as many as 7 days. Symptoms vary a great deal. In some patients there is only sore throat and swelling of the lymph nodes of the neck. The tonsils may be covered by a patchy purulent discharge. The bright red rash from which the disease takes its name appears on the second day; it may be mild or widely spread, depending on the strain of the causative streptococcus. The rash is caused by a toxin produced by scarlatinal strains. There may be nausea and vomiting. The skin usually feels hot and dry, and there also may be headache and chills. In mild cases the temperature may rise to about 38°C (101°F) and in severe cases to 39 to 40°C (103 to 105°F).

If there are no complications, the temperature will slowly return to normal. The rash may last only a few hours, but typically lasts two to three days before fading. There is superficial flaking of the skin over much of the involved area; this peeling is usually most pronounced on the palms and soles. In all, the active stage of the disease lasts about 7 days.Treatment. Antibiotics are administered, usually penicillin; this is continued for about 10 days to avoid relapse. Eating may be painful if the throat infection is severe, so that soft foods and a liquid diet may be necessary. Drinking of fluids should be encouraged.Complications. Among the possible complications are swelling of the lymph nodes of the neck, infection of the ears and sinuses, kidney disease, pneumonia, and rheumatic fever. Any of these complications may be serious. However, they are now rare in developed countries such as the United States and Canada. Prompt and adequate treatment greatly reduces the danger of complications.

scar·la·ti·na

(skar'lă-tē'nă), Avoid the misspelling scarletina.An acute exanthematous disease, caused by infection with streptococcal organisms producing an erythrogenic toxin, marked by fever and other constitutional disturbances, and a generalized eruption of closely aggregated bright red points or small macules followed by desquamation in large scales, shreds, or sheets; mucous membrane of the mouth and fauces is usually also involved. Synonym(s): scarlet fever [through It. fr. Mediev. L. scarlatum, scarlet, a scarlet cloth]

scarlet fever

n. An acute contagious disease caused by streptococcal bacteria, occurring predominantly among children and characterized by fever, sore throat, a rough, scarlet-red or dark rash, and often a whitish coating with red spots on the tongue. Also called scarlatina.

scarlet fever

Scarlatina Infectious disease A reaction to pharyngitis by Streptococcus group A–which produces an erythrogenic toxin, consisting of an oral enanthema–'raspberry' tongue, 'strawberry' tongue, generalized blanching erythema–sparing the palmoplantar region and mouth with circumoral pallor and linear petechiae–Pastia's lines. See Strep throat.

scar·la·ti·na

(skahr'lă-tē'nă) An acute exanthematous disease, caused by infection with streptococcal organisms producing erythrogenic toxin, marked by fever and other constitutional disturbances, and a generalized eruption of closely aggregated points or small macules of a bright red color followed by desquamation; mucous membrane of the mouth and fauces is usually also involved.
Synonym(s): scarlet fever. [through It. fr. Mediev. L. scarlatum, scarlet, a scarlet cloth]

scarlet fever

An infectious disease caused by STREPTOCOCCI (see STREPTOCOCCUS) acquired by inhaled droplets. Scarlet fever usually affects children but is now comparatively uncommon. It features sore throat, headache, fever and a characteristic rash caused by bacterial toxin. This starts as myriad tiny red spots spreading from the neck and upper chest to cover the whole body. The face is flushed but a pale zone is left around the mouth (circumoral pallor). The tongue has a white coating with red spots. As the rash fades there is skin peeling. Prompt treatment with penicillin is indicated to avoid the complications of streptococcal infection-RHEUMATIC FEVER or GLOMERULONEPHRITIS.

scarlet fever

an ACUTE, contagious disease in man, particularly of young children, caused by the bacterium Streptococcus pyogenes and characterized by inflammation of the pharynx, nose and mouth and a red skin rash.

scar·la·ti·na

(skahr'lă-tē'nă) Acute exanthematous disease, caused by infection with streptococcal organisms producing an erythrogenic toxin, marked by fever and other constitutional disturbances; mucous membrane of mouth and fauces is usually also involved.
Synonym(s): scarlet fever. [through It. fr. Mediev. L. scarlatum, scarlet, a scarlet cloth]

scarlet fever

scarlet fever

scarlet fever

scar′let fe′ver

scar·let fever

scarlet fever

scarlet

scarlet fever

scarlet fever

scarlatina,

Scarlet fever

Scarlet Fever

REFERENCE

scarlet fever

scarlet fever

scarlet fever

Scarlet Fever

Definition

Description

Causes and symptoms

Diagnosis

Treatment

Prognosis

Prevention

Resources

Books

scarlet fever

scar·la·ti·na

scarlet fever

scarlet fever

scar·la·ti·na

scarlet fever

scarlet fever

scar·la·ti·na

scarlet fever

Synonyms for scarlet fever

noun an acute communicable disease (usually in children) characterized by fever and a red rash

Synonyms

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