Toxic substances (called toxins) produced by scarlet fever streptococci are responsible for the typical symptoms. A passed through disease leaves only an immunity against these special toxins of the triggering streptococcus type. If scarlet fever breaks out, symptoms usually begin one to three days after infection.
Symptoms and course of scarlet fever
The following development of symptoms is typical for scarlet fever:
- At first, symptoms usually include high fever, feeling sick, and sore throat with difficulty swallowing (angina). Occasionally, headaches are also one of the symptoms.
- The throat and tonsils are reddened and the throat lymph nodes swollen.
- The tongue shows a whitish coating, which then recedes from the edges and gives way to a strong, shiny redness around the third to fourth day. The taste buds become prominent. This phenomenon is called “raspberry tongue” as one of the symptoms.
- The characteristic rash appears one to two days after the onset of the disease, which is usually accompanied by a decrease in fever. The rash consists of pinhead-sized raised spots. It makes the skin feel like sandpaper. The rash usually starts on the upper body and then spreads to the whole body. The mouth area is left out of the rash (“milk beard”), as well as the palms of the hands and soles of the feet; in the armpits and groins, the rash is most obvious.
- After a little over a week, the rash disappears, shortly after which there is a desquamation of the skin: on the hands and feet, large skin flakes (which are not contagious!).
Complications of scarlet fever
Fortunately, serious courses and sequelae are very rare in our country today. Possible complications are on the one hand – as with many other streptococci – the settlement of the pathogens elsewhere, which can lead, for example, to otitis media and sinusitis (sinusitis), purulent encapsulations (abscesses, for example, in joints, bone marrow or brain) or pneumonia.
A life-threatening – and today also rather rare – complication is flooding of the bloodstream with bacterial toxins (streptococcal toxic shock syndrome).
Sometimes the antibodies formed by the immune system against the scarlet streptococci are directed against the body’s own tissue. This can lead a few weeks later to inflammation of the kidneys (glomerulonephritis), inflammation of the joints (rheumatic fever), and inflammation of the heart muscle (myocarditis)-an extremely rare complication under antibiotic therapy.
