Scarlet fever is mostly a childhood illness transmitted by streptococcus bacteria. Typical signs of scarlet fever include a rash on the tongue, cough, sputum, runny nose, and fever. Scarlet fever is most often transmitted by droplet infection or direct contact.
What is scarlet fever?
Scarlet fever has been a well-known and once widespread childhood disease. Today, it is not as common. It is caused by streptococcus bacteria, which can also be responsible for other diseases. These include angina tonsillaris, tonsillitis and erysipelas. Similarly, scarlet fever can be a cause of secondary diseases, such as rheumatic fever. Scarlet fever occurs mostly in children in kindergarten and school and spreads among them by contact infection. Interestingly, babies have natural immune protection against scarlet fever and other childhood diseases until they are six months old. However, adults can also contract scarlet fever. The risk of infection is seasonally highest between October and March. If scarlet fever occurs, this disease must be reported immediately to the doctor to avoid further infections.
Causes
The cause of scarlet fever is infection with streptococcus bacteria (also called A streptococcus, Streptococcus pyogenes). In this case, the bacteria are transmitted either by direct contact with an infected person or by droplet infection (cough, cold). Similarly, infected food, drinks and objects can also be considered as a source of infection. Scarlet fever breaks out within one to three days after infection and the symptoms appear as typical symptoms. In the process, those affected can infect other people, so isolation and treatment are absolutely necessary.
Symptoms, complaints and signs
As the first symptom of the disease, a sore throat sets in quite suddenly. They are accompanied by more severe difficulty swallowing and often very high fever of up to 40 °C. This is accompanied by headache and nausea with vomiting. Patients often complain of abdominal pain and poor general condition. They feel fatigued and tired, and sometimes have chills. On the second day of the disease, the throat shows the typical red discoloration, the tongue is coated with pus, and the lymph nodes in the neck are swollen. The tonsils are enlarged, reddened and also covered with pus. In addition, a skin rash with pinhead-sized spots forms at the time. This velvety and non-itching exanthema starts on the chest, sometimes in the groin, and spreads over the whole body. It is most intense in the groin and on the inner thighs. The only area left out of the rash is the triangular-shaped area between the mouth and chin. After three to four days, the white coating on the tongue comes off and is shed. The inflamed and swollen papillae become visible and cause the typical raspberry-like appearance of the tongue. The so-called raspberry tongue is considered a characteristic symptom of scarlet fever. After two to four weeks, the rash disappears and the skin peels off in scales.
Course of the disease
An untreated course of scarlet fever can result in immense damage. Most importantly, it can lead to poisoning of various organs, circulatory failure, diarrhea, heart muscle inflammation, and vomiting. Likewise, streptococcus bacteria can spread with the bloodstream and subsequently lead to blood poisoning (sepsis). Sinusitis and meningitis are also possible. Late sequelae that can persist in the course of scarlet fever are heart valve defects, kidney disease and rheumatic fever. Pregnant women who are infected with scarlet fever do not leave any permanent damage to the still unborn child. Scarlet fever infected children treated by antibiotics can return to school or kindergarten after only a few days.
Complications
In modern times, serious sequelae of scarlet fever are rarely to be feared, thanks to the use of antibiotic drugs. However, there is a danger if the infection remains untreated. In such cases, there is a risk of streptococcal after-diseases such as rheumatic fever, rheumatic endocarditis or poststreptococcal glomerulonephritis. They belong to the immunological diseases.They are caused by the immune system‘s reaction to the germs that cause scarlet fever. They appear approximately four to six weeks after the infection. In addition, infections caused by streptococci are suspected to cause neuropsychiatric autoimmune diseases. These may include chorea minor, Tourette’s syndrome, or PANDAS. If the pathogens penetrate to the bloodstream, there is also a threat of dangerous toxic shock syndrome (TSS), in which there is severe organ and circulatory failure caused by the toxins of the bacteria. It is not uncommon for streptococci to be responsible for other secondary illnesses of scarlet fever infection. These purulent complications occur after the scarlet fever has healed. These are often inflammation of the sinuses, acute inflammation of the middle ear, meningitis or streptococcal sepsis. Furthermore, the formation of abscesses on the connective tissue of the palatine tonsils is possible. The risk of scarlet fever complications is particularly pronounced in adult patients. Thus, those affected usually first try self-therapy instead of quickly going to a doctor.
When should you see a doctor?
Rising fever and the characteristic red coloration of the throat and tongue indicate scarlet fever. The child should be seen by a doctor if the symptoms appear to occur overnight and do not resolve within a few hours. If, in addition, the lymph nodes in the neck swell or accompanying symptoms such as abdominal pain and malaise occur, it is best to consult the doctor immediately. An immediate visit to the doctor is also indicated if a streptococcal infection is circulating in the child’s kindergarten or school. Adults who notice the above-mentioned symptoms should consult their family doctor as soon as possible. Further contact points are the dermatologist or an internist. If scarlet fever is treated early, it should resolve within a few days. Very high fever and increased gastrointestinal symptoms indicate a complicated course of the disease. If the patient’s condition does not improve despite bed rest and drug treatment, hospitalization may be necessary. The family physician or pediatrician should be informed immediately of persistent symptoms and complaints.
Treatment and therapy
The regular treatment of scarlet fever is antibiotics (penicillin). In any case, a doctor should therefore be consulted in the case of scarlet fever, since on the one hand there is a duty to report and on the other hand, self-treatment is strongly discouraged. Above all, the unpleasant symptoms of the disease, such as cough, headache, sore throat, fever and aching limbs, should be alleviated and the streptococcus bacteria eradicated. If the patient is intolerant to the antibiotic medication or has an allergic reaction to it, alternatives such as cephalosporin, roxithromycin or erythromycin can also be prescribed by the doctor. In addition to the general initial examination, a second examination should also be performed by the physician after one to two weeks. Here, a urine sample is usually taken and examined. This is to determine whether a so-called renal corpuscle inflammation has developed in the body or in the urine. Likewise, attention should also be paid to blood residues in the urine. In addition to the medical examination and treatment, the person affected by scarlet fever should in any case observe strict bed rest. In addition, the child should not be able to infect other people. Therefore, the patient should be treated in relative isolation. Children with scarlet fever in particular should drink plenty of fluids and cough up cough mucus regularly. Cough expectorants can be purchased in all common pharmacies, mostly without prescription. Furthermore, one should provide in the rooms for something more humid and cooler air.
Aftercare
A survived scarlet fever, which mostly occurs in children, does not require special aftercare. Provided the child has been treated with antibiotics, he or she can usually return to kindergarten or school after three weeks. Re-infection can be prevented primarily by isolating sick children as much as possible from other children as soon as possible for the period of treatment and when the illness has subsided, and by providing rapid treatment. This is because scarlet fever usually spreads via droplet infection. Therefore, disinfection of the affected child’s environment, such as toys, is advisable to prevent spread.The doctor must decide when the child can return to the KITA. To avoid scarlet fever, regular hand washing with soap is also important to limit the bacteria on the hands. In rare cases, late complications can result from scarlet fever. Therefore, it is important that the affected person is treated by a doctor, who can also determine when the disease is over or may require further treatment. In most cases, however, this does not occur, so follow-up care for scarlet fever is not necessary.
What you can do yourself
In scarlet fever, accompanying medical treatment, some measures can be taken by the patient himself. First, the affected child should take it easy. Sufficient sleep is important for the recovery process, as the immune system is heavily burdened by the disease and needs rest. Parents should also make sure that the child drinks enough water or tea. Especially for toddlers and babies, a balanced fluid balance is important to avoid dehydration of the mucous membranes or dehydration. Humidity in the premises should be as high as possible. A damp towel on the radiator or a humidifier are proven ways to moisten the room climate. For sore throats, gargle solutions, inhalations and throat compresses help. Classics such as chicken soup also help, because they supply the body with minerals and have an anti-inflammatory effect. In addition, they keep the mucous membranes moist and serve to hydrate. In case of fever, calf compresses and cooling compresses help. Parents should watch for any warning signs. If the fever continues to rise or if severe coughing spasms occur, the doctor must be consulted. The scarlet fever should have subsided after a few days. If symptoms persist, medical advice is also required, as complications may be present. The doctor may also prescribe homeopathic remedies such as belladonna, stromonium and ipecacuanha. The medicinal plant ointment also helps, as do nasturtiums, Iceland moss and salt pastilles.
