Scarlet fever

Scarlet fever - an acute infectious disease characterized by phenomena of intoxication, catarrhal or necrotic angina, petechial rash on the background of erythema throughout the body.
Etiology of scarlet fever is unclear. The most common are two theories: strep and virus. Supporters of streptococcal theory consider the causative agent of scarlet fever haemolytic Streptococcus group a, which is found on the mucous membrane of the mouth and nose in patients with scarlet fever. For streptococcal etiology says the reaction dick, which consists in intradermal a streptococcal toxin (0.1 ml thermolabile faction toxin dick). Noted that the positive reaction (redness at the injection larger than 1 cm) diagnosed in children susceptible to scarlet fever.
Supporters of the viral theory consider the causative agent of scarlet fever filterable virus that is in the state of biological connection with the Streptococcus.
Epidemiology. The source of infection is a sick and healthy media hemolytic Streptococcus. The patient is contagious throughout the disease. More sick children at the age from 1 year to 10 years. The infection is transmitted by airborne droplets, and through toys and items of personal use.
Of particular danger are sick atypical mild form of scarlet fever, which can be difficult to diagnose. Maximum morbidity is observed in autumn-winter period.
Pathogenesis and pathological anatomy. In the pathogenesis of scarlet fever are three main components: toxic, infectious (septic) and allergic.
At the beginning of the disease is more often expressed in the phenomenon of toxicosis (high temperature, headache, rash, vomiting, sometimes convulsions, loss of consciousness)that develop under the influence of the toxin of the pathogen. The allergic component of sandwiches on toxic in the first days of the disease and is maintained throughout diseases; clinically manifested wavy course of scarlet fever with the rise of temperature, the exacerbation of angina. Allergy causes a decrease in the protective forces of the organism, which leads to a septic phenomena: necrotic angina, purulent the lymphadenitis, otitis, abscess, pneumonia, purulent the pleurisy and other
Autopsy picture with scarlet fever depends on the form and duration of the disease. Toxic forms changes are brought to the surface the defeat of the throat and tonsils, the moderate reaction of the regional lymph nodes, destructive changes of the vegetative nervous system, rebirth parenchymatous organs. In septic scarlet fever is marked foci of necrosis on the tonsils and the mucous membrane of the mouth, inflammation of the regional lymph nodes with foci of necrosis, acute swelling of the spleen, degeneration of the internal organs. Kidney observed septic interstitial nephritis, in adrenal - swelling, bleeding and alopecia necrosis.
Children who recover from typical form of scarlet fever remain immune for life. Children in the first year of life have a natural immunity.

  • The clinical picture
  • The diagnosis is based on clinical and epidemiological data. Differential diagnosis should be carried out with measles, serum disease, diphtheria throat, skarlatines rubella.
    Treatment. In the treatment of scarlet fever are of great importance care, hygiene, especially the care of an oral cavity and pharynx. Appoint symptomatic funds, as well as antibiotics in doses appropriate to their age. In severe toxic form of scarlet fever is administered intramuscularly Besedke (see Besedki method) antitoxic protivokariosnoe serum 30 000-50 000 AE, solutions of glucose; plasma transfusions.
    Prevention. Sick with scarlet fever be hospitalized for clinical and epidemiological indications (severe disease, breast age, contact with healthy children). If hospitalization is important to observe a one-time filling of the chambers of the patients. Convalescents allowed in children's groups 12 days after the end of isolation. Children, not ill with scarlet fever, dismantled by 7 days of isolation of the patient (see the Isolation of infectious patients). In the apartment, where there are ill with scarlet fever, conduct disinfection of the current.