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Scarlet fever

Scarlet fever is a exotoxin mediated disease caused by Group A streptococcal infection that occurs most often in association with a sore throat and rarely with impetigo or other streptococcal infections. more...

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It is characterized by sore throat, fever and a rash over the upper body that may spread to cover almost the entire body. Scarlet fever is not Rheumatic fever. Rheumatic fever is the autoimmune disease that occurs after infection with Group A strep that causes damage to your heart valves.

History

This disease was also once known as Scarlatina. Many novels depicting life prior to the nineteenth century (see Scarlet Fever in literature below) describe scarlet fever as an acute disease being followed by many months spent in convalescence. The convalesence was probably due to complications with rheumatic fever. It was also not uncommon to destroy or burn the personal affects of a person afflicted with scarlet fever to prevent transmission to other people.

It is to this effect that people once greatly feared this disease. It killed many thousands of people, which is why, today, many people especially of the older generation still fear this disease, even though it is fairly easy to treat with modern antibiotics.

Scarlet fever in literature

  • Little Women by Louisa May Alcott (1868) - Beth contracts Scarlet Fever and after a long convalesence, succumbs to the illness.
  • The Velveteen Rabbit by Margery Williams (1922) - The main protagonist, a small boy, contracts scarlet fever and his toys are all burned.

Signs and Symptoms

The disease is typically preceded by:

  • fever
  • fatigue
  • sore throat.
  • There is a characteristic rash:
  • fine, red, rough-textured and blanches upon pressure
  • appears 12-48 hours after the fever
  • generally starts on the chest, axilla (armpits), and behind the ears
  • worse in the skin folds
  • Pastia lines (small linear petechiae) appear and persist after the rash is gone
  • Scarlet fever also produces a bright red tongue with a "strawberry" appearance.
  • The area around the mouth is usually pale (circumoral pallor)
  • After about a week, the skin often desquamates or peels, usually in the groin, axilla, and on tips of fingers and toes

Transmission

The illness is spread by the same means as strep throat.

Treatment

Other than the occurrence of the rash, the treatment and course of scarlet fever are no different from those of any strep throat.

Antibiotic treatment is necessary to prevent rheumatic fever.

Resources

  • eMedicine (emerg/518)
  • MedlinePlus Encylopedia 000974


Read more at Wikipedia.org


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Scarlet Fever
From Gale Encyclopedia of Childhood and Adolescence, 4/6/01

Scarlet fever occurs most often during the winter months. Children between the ages of three and 12 are the most susceptible. It is extremely contagious, spread by coughs and sneezes.

Scarlet fever comes on suddenly with a fever of 103°F (39.4°C) or higher, accompanied by a sore throat, physical weakness, headache, nausea, and stomachache. The high fever may cause convulsions.

Twelve to 48 hours after the onset of fever, a fine, rough rash (often likened to sandpaper or sunburn with goosebumps) appears in the armpits and groin and on the neck and inner thighs. It then spreads out to the chest, back, arms, and legs. The roof of the mouth may also break out, and the throat and tonsils appear bright red. The child's tongue is first covered with a white, fuzzy coating before changing to bright red. The rash lasts two to three days and then the skin begins to peel off in flakes, scales, and sheets. The face is usually the first to peel. The peeling lasts from three to eight weeks depending on the severity of the case.

The rash of scarlet fever is often confused with that of the measles (rubeola ),German measles(rubella, toxic shock syndrome, heat rash, or sunburn. Therefore, the child should be seen by a physician on the first day that the rash breaks out. The doctor takes a throat culture to verify a strep infection and then prescribes an antibiotic. While the fever lasts, the child needs plenty of rest, fluids, and a fever-reducing medication. If left untreated, scarlet fever can lead to a middle-ear infection and/or abscess of the tonsils. In rare cases, the disease results in rheumatic fever and nephritis (inflammation of the kidneys).

Further Reading

For Your Information

Books

  • Fry, John, and Gerald Sandler. Common Diseases: Their Nature, Prevalence, and Care. (5th ed.) Boston: Kluwer Academic Publishers, 1993.
  • Hamann, Barbara P. Disease: Identification, Prevention, and Control. St. Louis: Mosby, 1994.

Gale Encyclopedia of Childhood & Adolescence. Gale Research, 1998.

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