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Scarlet fever is an acute illness of infectious character. At scarlet fever children and adults have a display of fever, a punctate rash, the general intoxication of an organism, quinsy. The causative agent of scarlet fever is the streptococcus of group A.
This disease for the first time was described in 1564. Its name comes from the English combination of words designating "purple fever". It was quite so accepted to call scarlet fever in the seventeenth century.
Most often scarlet fever occurs at children when the child goes to children's organized collectives. Scarlet fever mainly arises during the cold period, less cases are fixed in the flying. One more feature of incidence of scarlet fever – periodic rises and recessions of incidence. So, incidence increases once in several years.
Scarlet fever reasons
The streptococcus of group A which provokes development of scarlet fever, causes also some other streptococcal infections. It is quinsy, rheumatism, an adenoid disease, a streptoderma, etc. The streptococcus of group A produces exotoxin under the influence of which at the person symptoms of the general intoxication, a dieback are shown. A source of an infection is the person who have scarlet fever, quinsy, and also other forms of a streptococcal infection. It is possible to catch a disease and from those carriers of streptococci of group A at which the disease is not shown. Constitutes the greatest danger of the patient for an environment in the first days of development of an illness. However already three weeks later after the beginning of a disease its transmissibility stops. Many carriers of streptococci of group A occur among people today. There are data that those are about 15% of the population. The infection is transmitted to the person in the airborne way through the aerosol mechanism. As a rule, people catch scarlet fever after very close contact with sick or healthy carriers of a streptococcus. Besides, it is possible to catch also an alimentary way (through food), and also contact (using household items, through dirty hands).
Mainly symptoms of scarlet fever are shown at people who have no anti-toxic immunity.
The activator is implemented into a human body through mucous membranes of a nasopharynx and a pharynx, very seldom infection occurs through mucous generative organs. Further the activator, moving on absorbent vessels, gets into lymph nodes and there collects. In this regard inflammatory reactions of which emergence of the centers of a necrosis and a leukocytic infiltration is characteristic develop.
Scarlet fever symptoms
As a rule, duration of an incubation interval makes from one to ten days. Generally scarlet fever at adults and children begins sharply. Sometimes even during the first hours courses of a disease appear pronounced symptoms of scarlet fever: sharp jumps of body temperature which increases up to high rates, a noticeable indisposition, headaches, tachycardia, weakness. To the patient the stomach can sometimes hurt.
If at the person fever takes place, then in the first days of an illness he can be too excited and mobile or, on the contrary, sluggish and weak with the expressed drowsiness. Sometimes there is vomiting as an effect of the general intoxication. However symptoms of scarlet fever are not always shown quite so. Today many cases when scarlet fever at children and adults develops at low body temperature are fixed.
In the course of progressing of a disease of the patient complains of pain in the course of swallowing. The doctor, examining the patient, notes existence of a bright diffuse hyperemia of almonds, a uvula, handles, a soft palate, and also back wall of a throat. In comparison with quinsy symptoms in this case more intensive hyperemia is noted, its restriction is also noticeable where mucous passes into a hard palate.
At scarlet fever manifestation mucopurulent, and in certain cases and necrotic plaques on almonds is possible. At the same time there are also symptoms of regional lymphadenitis at which morbidity and density of perednesheyny lymph nodes is observed.
Initially as a scarlet fever symptom at the patient the plaque of a gray-white shade in language is observed, however in several days language becomes pure, bright red. Nipples on it are hypertrophied. If scarlet fever passes into a severe form, then the crimson color is swept up also on the patient's lips. When listening cordial rhythms tachycardia, at the same time pressure which is moderately increased is noted.
Already on the first or second day of an illness the patient has a scarlatinal dieback. It is located on the general hyperemic background. The most important symptom of scarlet fever in the course of diagnosis of an illness is rash. Initially the rash consisting of small red points develops on a face, on a neck, on upper part of a trunk. There is its fast distribution on a flexion surface of extremities, on a stomach and a breast a little later. Rash on the interior of hips is possible. One more defining symptom of scarlet fever is rash which is condensed in the form of strips of red color on skin folds in places of bends, armpits. Sometimes small red points merge that makes impression of existence of a continuous erythema.
Rash on a face of the patient is on cheeks, it is expressed to exchange on a forehead, on temples. After emergence of rash of the patient feels a constant itch. At the same time it is expressed pale the nasolabial triangle which is free from rash is.
Sometimes scarlet fever at adults and at children is shown not only rash, characteristic of this illness, but also small vesicles and papular elements. At scarlet fever emergence of rash happens approximately for the third day, however sometimes it in general is absent. In three-four days of the patient feels better, it lowers body temperature, displays of rash gradually disappear. On site red points after their disappearance the skin peeling is observed.
Types of scarlet fever
Scarlet fever can proceed in an easy, medium-weight and severe form. Besides, there is also other classification of a disease.
At ekstrabukkalny scarlet fever the infection gets to an organism through the skin affected earlier: the activator is implemented through wounds, burns, etc. At the same time distribution of rash happens from that place where earlier the activator was implemented. The inflammation in a stomatopharynx and in cervical lymph nodes is not observed. This form of scarlet fever is shown today very seldom.
At the erased scarlet fever forms symptoms are expressed poorly, they remind all-toxic signs. Scarlet fever at adults is most often shown in such form. At the same time changes of catarral character in a stomatopharynx, small and quickly disappearing rash are observed.
But sometimes scarlet fever at adults is shown in a toksiko-septic form and passes very hard. Such form of a disease develops infrequently. It begins very violently, at the same time the patient has a hyperthermia, vascular insufficiency which develops very quickly, sometimes on skin hemorrhages appear. A little later other complications also join these symptoms of scarlet fever. In rate kidneys, heart, joints are surprised. Also there can be septic complications which are expressed by lymphadenites, necrotic quinsy, etc.
Complications of scarlet fever
Most often as complications of scarlet fever at patients purulent otitis, purulent and necrotic lymphadenitis are shown. Also infectious and allergic complications, for example, myocarditis, a diffusion glomerulonephritis are possible. The last is more characteristic of adults.
Diagnosis of scarlet fever
In the course of diagnosis of a disease it is important to distinguish scarlet fever from a pseudotuberculosis, measles, a rubella, sometimes, at the corresponding symptoms — from diphtheria. The doctor performs inspection, and in the presence of the symptoms characteristic of scarlet fever described above, appoints further researches which can confirm existence of an illness. If at the patient rash takes place, the doctor in the course of survey pressures her a palm then rash for some time disappears.
To the patient with suspicion laboratory blood analyses are also appointed to scarlet fever. Their results show existence of changes which are typical for a bacterial infection. During diagnosis do not practice allocation of the activator.
Treatment of scarlet fever
Treatment of scarlet fever is carried out, as a rule, out of a hospital today. Hospitalization of the patient is made only in very hard cases and in the presence of complications of scarlet fever. In the course of treatment of scarlet fever observance of a high bed rest within, at least, week is very important. Generally treatment of scarlet fever assumes purpose of a course of reception of penicillin. As alternative drugs in this case use erythromycin, Cefazolin. Therapy by these drugs has to continue ten days.
If the person has contraindications to the listed medicines, then such patient appoint semi-synthetic penicillin, linkozamida. Besides, treatment of scarlet fever assumes periodic rinsing of a throat. For this purpose both Furacilin solution, and infusions of medicinal herbs, for example, of a calendula, camomiles, an eucalyptus, a sage approaches. It is also useful to drink herbal teas from collecting herbs with antiinflammatory influence. Also the course of treatment of scarlet fever includes reception of vitamin complexes and antihistaminic drugs. Periodic reception of febrifugal drugs is sometimes reasonable. Rash disappears in process of recovery and does not demand use of additional local resources for treatment.
Besides, in the course of recovery the patient has to drink a lot of warm liquid, and in the first days of an illness it is necessary to use warm, semi-fluid food. It is desirable to give to the sick child compotes, juice, kissels, milk soups, broths.
It is important that more painfully scarlet fever were in isolation. If scarlet fever at children takes place, then the sick child should not contact to other children, and in children's collective it is allowed not earlier than in twelve days after recovery. At display of an illness at children from child care facilities declare week quarantine there.
Prevention of scarlet fever
Today there is no special scarlet fever vaccine. Therefore as preventive measures the quarantine actions concerning the child who got sick with scarlet fever are applied. It is not less important to take all measures in order that the host defense of an organism of the child who had scarlet fever raised. For this purpose parents have to provide regular carrying out actions which promote immunity strengthening. It is about a gradual hardening, the correct approach to providing a healthy food allowance, observance of all rules of hygiene. Parents have to watch also that the child timely passed routine inspections at the doctor and received adequate treatment at diseases of gums and teeth, sinusitis, tonsillitis, otitises.