A Simple guide to Scarlet Fever

A Simple guide to Scarlet Fever
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What is Scarlet Fever?
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Scarlet Fever is an acute febrile infectious disease of the upper respiratory tract caused by the erythrogenic toxin associated with the bacillus Group A Streptococcus(GAS).

How is Scarlet Fever transmitted?
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Scarlet Fever is transmitted through the air through
1.droplets from the infected tonsillar or pharyngeal area of infected patients.
2.infected articles or food,
3.infected wounds or
4.infected umbilical stumps of neonates 

It is highly infectious, being communicable from 24 hours before onset of symptoms to 2 to 3 weeks after onset of symptoms.

Asymptomatic carriers can also spread the disease.

Incubation period is 2 - 5 days.

The organism enters the blood from the throat and produce an erythrogenic toxin which causes  the symptoms of fever and rash.

The rash is the main symptom which gives rise to the scarlet appearance, hence the name Scarlet Fever.

The infections occur in persons of all ages but peak incidence is 5- 15 years. Males are affected equally as females.

Usually 1 attack will confer permanent immunity to the erythrogenic toxin of GAS streptococcus.

What are the Signs and Symptoms of Scarlet Fever ?
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Symptoms start off with:
1. sudden onset of headache

2. high fever 39-40 degrees centigrade

3. chills and rigors

4. sore throat(infected tonsils)

5. vomiting

6. cervical lymphadenopathy

Subsequent symptoms follows:
1.punctate erythrematous rash appearing 12 to 24 hours later after the fever, starting from the neck and chest then spreads rapidly.
The face is not affected.

2.Facial flushing and pale area around the mouth

3.Dark red lines along skin creases (Pastia's lines)

4.Rash blanches when pressed

5.Tongue coated with white fur with occasional red papillae (white strawberry tongue) The white fur peels on the third day and becomes red by the fourth day (red strawberry tongue)

How to diagnose Scarlet Fever?
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1.Symptoms of fever and rash
2.ESR raised very high somtimes > 80
3.moderate leucytosis
4.Throat swab for culture and sensitivity

What are the complications of Scarlet Fever?
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1.otitis media

2.rheumatic fever

3.glomerulonephritis

4.henoch-schonlein purpura

What is the Treatment of Scarlet Fever?
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Isolation in hospital may be needed.
1.Antibiotics (penicillin or amoxicillin) are used in the treatment of Scarlet Fever. Treatment is for at least 10 days.
Alternatives are cephalosporins such as cephelexin in penicillin sensitive patients
2.Paracetamol is given for fever and pain
3.Bed rest , fluids and general supportive care

What is the Prevention for Scarlet Fever?
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Avoiding infected patients
Recently there are new cases of Scarlet Fever in Hong Kong.

What is the Prognosis of Scarlet Fever?
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In fact after the introduction of antibiotics, there is very few cases of Scarlet Fever.
Early therapy with antibiotics produce excellent recovery
In rare cases complications such as rheumatic fever and glomerulonephritis can occur