Scarlet fever in children: symptoms, photo, treatment and prevention

Scarlet fever - a childhood illness, referring to a class of bacterial infections. Characterized by inflammatory processes in the lymphoid tissue of the tonsils, nonspecific disturbances in thermoregulatory system of the body and intoxication syndrome, profuse rash on areas of the body and face (See photo).

Pathogen causes a disease related to the labeling of the beta hemolytic Streptococcus bacteria class, wherein high aggressiveness. Getting inside the body produces very poisonous eritrotoksiny nicknamed medical "red poison." Impacts are inherent only in this class due to streptococcus and pathological processes that modify the mucosa and skin.

What it is?

Scarlet fever - infectious disease caused by hemolytic streptococci usually Group A (Streptococcus pyogenes). It appears punctate rash, fever, general intoxication. The source of infection in scarlet fever is a human.

How do you get scarlet fever?

Infection scarlet fever may occur by droplets and contact-household - that is, if in the same room with infected person to communicate with him, as well as access to a shared utensils and other household articles, and it is possible to feel the symptoms disease. Also, sometimes the infection gets into the bloodstream through a cut, wound.

The site of Dr. Komarovsky pointed out that unlike some other infections, the person becomes contagious, once it have the first signs of scarlet fever. The causative agent of the disease - beta-hemolytic streptococcus group A. Bacteria throughout his life secrete toxin which enters the bloodstream and causes the clinical manifestations of scarlet fever.

There is a hypothesis, according to which the most likely to develop this disease children with the following risk factors:

• AIDS or any other immune disorders;
• diabetes, adrenal pathology;
• chronic tonsillitis;
• atopic dermatitis in children;
• various forms of exudative diathesis;
• reduced body weight (or malnutrition);
• chronic pathological changes in the nasopharynx;
• regular intake of corticosteroids or any other means of reducing the severity of an immune response.

Most often, adults do not become infected with scarlet fever, even if it gets sick their son or daughter. This is due to stronger adult immunity. Also, if mom and dad as a child suffered the disease, they received a kind of "vaccination" - they have developed a special immunity to the infection. However, in rare cases, adults still get sick. Scarlet fever they cause mild or severe form.

What happens in the body after infection?

The penetration of the pathogen into the body of scarlet fever in the majority of cases (ie 97%) takes place through the throat, sometimes "the gates of infection" - is damaged skin (burns, scrapes, sores - 1.6%), human lung (1%), sometimes genitals (lining of the uterus so called postpartum scarlet fever).

Getting on mucous or wound surface, Streptococcus group A - exciter scarlet fever - causes inflammation of the tissue at the site of introduction, followed by death and cell rejection. After streptococcus through the lymphatic vessels and blood enters the lymph nodes located near (in the case of penetration through mucous infection of the upper respiratory tract are affected sublingual, submandibular, cervical group lymph nodes).

In the normal course of "living" streptococcus produces a toxin that resembles the autonomic nervous system and neuro-vascular apparatus. Causing a chain of pathological changes in the organs and the organism of the patient, the infection determines the main symptoms of scarlet fever in children: fever, acute inflammation of the tonsils, a rash on the face and body, the defeat of the cardiovascular system of the body, violations of the central and autonomic nervous systems.

Classification

Types and symptoms of typical forms of scarlet fever:

• moderate forms - high fever, severe rash, purulent tonsillitis, vomiting. Duration of disease 6-8 days.
• a mild form - the temperature to 38.5 C, a light rash, mild sore throat. Duration of disease 4-5 days.

Severe form is of three kinds:

• septic - necrotic angina, inflammation of the surrounding tissue.
• septic-toxic - the combination of signs of the previous forms.
• toxic - the temperature to 41 C, the degree of intoxication heavy, frequent vomiting, loss of consciousness, hallucinations, delusions.

Atypical scarlet fever can occur in the following forms:

• rudimentary - main symptom unit performs rash; disease in this form lasts no longer than 2 days.
• blurred - the symptoms of scarlet fever are minimal, no rash, pain when swallowing, redness of the throat, slight fever.

When ekstrafaringealnoy form affects the fabric of regional lymph nodes and oropharynx, develops lymphadenitis. hardly affects the tonsils.

incubation period

The first symptoms of the disease appear on average 3-7 days after infection. Most often, the incubation period in children lasts two or three days. Sometimes it is reduced to a single day or even several hours. In rare cases, the incubation period may be extended to twelve days.

Symptoms and signs of scarlet fever in childhood

The first symptoms of scarlet fever are the symptoms of acute intoxication body of the child:

1. Drowsiness, lethargy, weakness, fatigue, irritability;
2. Headaches and body aches, refusal to eat. May experience severe abdominal pain. Young children may have vomiting or diarrhea;
3. The sharp rise in temperature. Body temperature usually increases sharply and at Day 2 reaches maximum 39-40 ° C. Over the next 5-7 days, the temperature is gradually returning to normal;
4. Complaints of pain in the throat. Appears redness of the throat (tonsils are often covered with patina) as in tonsillitis or sore throat. Marked increase in morbidity and regional lymph nodes.

These symptoms do not reveal the scarlet fever, because exactly the same symptoms can also occur in many other diseases such as angina. But fairly quickly develop symptoms characteristic for scarlet fever:

1. Raspberry language. In the first days of illness tongue covered with white bloom, through which shine red edematous papillae. A few days later the raid exfoliated, the tongue becomes bright red, shiny, "raspberry".
2. Rash. Typical for scarlet fever rash appears after 12-48 hours. rashes on the skin look like small red dots. At first, the rash appears on the neck and upper chest, but then quickly spread to the whole body and face. The rash of scarlet fever never appears in the nasolabial triangle. Pallor of nasolabial triangle of scarlet fever is particularly emphasized flushed cheeks and swollen lips bright child. If the place of formation of the rash your finger for a while is a white bar that slowly changes its color back to white to bright red. In the deep folds of the skin (in the elbow, axillary, popliteal folds in the groin area), stripes may appear dark red color, which does not fade when pressed.

On the 4-5th day of illness (sometimes earlier), the rash begins to fade and disappear. After the disappearance of the rash at the end of the first - at the beginning of the second week of the disease on the face of the skin starts to peel off in the form of delicate flakes. Then peeling appears on the trunk and the least - in the hands and feet. The skin peels off layers of scarlet fever, especially in the hands and feet. Duration and intensity of the peeling depends on the severity of rash, the length of this period may be delayed up to 6 weeks.

With regard to the organs of the digestive system, in scarlet fever is not their function is impaired drastically. For most patients, characterized by constipation, but in infants is more common diarrhea.

It looks like scarlet fever children: photo

The photo below shows how the disease manifests itself in the child.

How to distinguish between scarlet fever from other diseases

A red rash on the skin can appear under some other diseases: measles, rubella, Atopic dermatitis. Purulent inflammation of the tonsils is also not necessarily a manifestation of scarlet fever, as a defeat of the tonsils and the nearest to the downstream region may, for example, and diphtheria.

Scarlet fever can be distinguished by the following features:

1. White nasolabial triangle.
2. Spot red swollen rash on the skin. Especially densely located rash in skin folds and folds on the limbs.
3. "Burning shed." Mouth and throat red, swollen. FIELD redness separated by a sharp boundary sky.
4. "Strawberry tongue" - swollen tongue crimson, which enlarged nipples stand out.
5. peeling of the skin after the start of recovery. On the palms and soles of the feet it goes bands, and in other places - small scales.

re scarlet fever

Normally, after the transfer of scarlet fever the body produces antibodies to eritrotoksinu. But if the immune system is very weak, it can be repeated attack pathogens, which occurred even before a complete cure. And if the disease enters the next level in a seemingly began to recover the child.

A re scarlet fever disease long after the transferred disease noted in 2 - 4%. This is attributed to the fact that the use of the antibiotic since the early days of the disease organism does not have time to develop antibodies eritrotoksinu

But the second time the scarlet fever, as a rule, is held in a milder form. Similar treatment is applied, except that the doctor may prescribe another antibiotic, not the one that was the first time.

possible complications

In the absence of adequate treatment and for some other reason (weakness of protective forces, infection highly aggressive strain of streptococcus, a predisposition to autoimmune processes) can develop complications.

All the effects of scarlet fever is divided into three large groups:

1. Septic. This group includes a variety of purulent infections - common necrotic angina, otitis, Purulent lymphadenitis, peritonsillar abscess, pneumonia etc. The most severe sepsis and purulent meningitis. Septic complications can be early (occur in the first week of illness) and late (occurring after 2 or more weeks). Septic complications usually associated with inadequate antibiotic therapy (late appointment, unfinished course, inactive against streptococci drug) or no antibiotics in the treatment patients.
2. Allergic (infectious-allergic) - always late, formed to 2-3 week. These include the failure of the joints, kidneys, heart recovering from scarlet fever. Allergic complication caused by that streptococcus antigens is similar in structure to some cells of the human body. Because of this similarity of the immune system, since the fight against streptococcus affects not only alien microbial cells, but also their own - develops autoallergichesky rheumatism, myocarditis, glomerulonephritis etc. To prevent infectious and allergic complications, it is necessary to begin antibiotic therapy as early as possible and to carry out a full course.
3. Toxic. These include toxic shock developing in the first days of illness against infection lots of highly aggressive and highly toxic strain of streptococcus. It is characterized by severe weakness up to loss of consciousness and coma, pallor, drop in blood pressure, respiratory depression, disorders of the heart, and so on. D. At present, very rare.

If timely treatment of scarlet fever occurs quite easily: the temperature is reduced by 3-4 days of disease, to the same time (or even earlier) are rash. Change the language, dryness of the skin followed by peeling may persist for weeks 2-3.

Diagnostics

Diagnosis expose based on clinical manifestations, epidemiological data (contact with the patient any form of streptococcal infection). Also use laboratory diagnostics. In the acute phase, all patients prescribed blood count. For scarlet fever is characterized by increasing the number of leukocytes and neutrophils in the blood, increased erythrocyte sedimentation rate, which indicates the cause of bacterial infection.

For diagnosis acknowledgment use bacteriological method, in which the release of beta-hemolytic streptococcus in crops of mucus from the oropharynx. Modern diagnostic methods include determination of titer-antistreptolysin O antibodies against DNase and other enzymes, including streptococci and antitoxins.

Than to treat scarlet fever?

Mild cases of scarlet fever in a child being treated at home, heavy - in a polyclinic. Both in one and in the other case, patients are administered antibiotics penicillin if there is intolerance of these drugs - other groups of antibiotics.

Duration of treatment is determined individually, but on average - is 10 days. Twenty-four hours after the start of therapy significantly improves the human condition, but antibiotics must always be completed.

In addition to antibiotic treatment scarlet fever includes:

1. Bed rest.
2. Pharmacological symptomatic therapy - antipyretic drugs, antiallergic drugs and other means.
3. Diet (diet should be warm, not solid, better to give preference to vegetables and fruits), excessive drinking, which is necessary to reduce toxicity.
4. Local treatment - lozenges and sprays with anesthetic and antiseptic action, gargling solutions furatsilina, soda, decoctions of herbs.

Resuming Active garden or school children, been ill with scarlet fever, it is possible not earlier than three weeks after the onset of the disease, even if the patient's health condition will improve a lot before.

The image of the child's life during illness

Infection weakens the baby, so it is necessary to provide a confinement to bed, in a room without a bright light and loud noises. To minimize the level of stress factors.

Despite the fact that in our society accepted zakarmlivat ill children, in the case of scarlet fever is better not to do so. Giving should eat slowly, all products must be boiled thoroughly and frayed, so they are easy to swallow. Food must be warm and not hot. Diet thus eliminates sharp, salty and spicy foods, which irritate the throat. As for the drinking regime, the need to drink a lot. It is better if it is alkaline warm drink. Access to the baby should be around the clock. We can not allow dehydration. Water is necessary to fractionally, ie on the throat, but often.

Bathe your baby during a scarlet fever is not desirable, at least for the first 5-7 days. Changing temperatures and too much stimulation will only reinforce the manifestation of the rash. Handle anything rash, too, not worth it.

Can I bathe the baby?

Washing is not prohibited in scarlet fever. On the contrary, children should bathe as this will reduce the itching and scratching will be the prevention of rashes.

However, it is important to follow some rules:

• bathwater should not be too hot or very cool.
• if a child has a fever, replace the bath sponging.
• the skin should not be rubbed a washcloth or sponge.
• to wash suds instead of a shower is better to make pouring from a dipper.
• after bathing towel baby are advised not to. Better water get wet, wrapped the baby in a sheet or diaper.

prevention

Since the patient is a child with scarlet fever is contagious for 22 days from the onset of the disease, in the kindergarten and the school conducted quarantine measures:

1. Uninfected children with scarlet fever, in contact with the patient are isolated for 7 days (this rule applies to preschools and grade 1-2).
2. Allowed to visit the previously bolevshie scarlet fever and the children have recovered after 12 days after the removal of the clinical manifestations.
3. The admission in an institution recover from acute respiratory infections, sore throat and other respiratory infections are permitted if there is a certificate with confirmation of antibiotic treatment.
4. Fixed within 7 days after the last registration of children with scarlet fever and sore throat are isolated for 22 days from the onset of symptoms.
5. Workers (decreed group), and bolevshie previously been in contact with the patient are allowed to work for them is established 7-day medical supervision.
6. Current disinfection is conducted with 0.5% chloramine, dishware, and laundry boiled. Final disinfection impractical.
7. Employees of children's institutions after the disease for 12 days are transferred to a job where they are epidemiologically harmless.

Each time after clamping scarlet fever quarantine extended for a further 7 days.