Scarlet Fever

Scarlet fever, also known as scarlatina,is an infection caused by bacterial intoxication and causes strep throat. Bright red rash that covers most of the body is the characteristic feature of this infection. Sore throat and fever are commonly seen during this infection. Scarlet fever is commonly seen in children from 5 – 15 years of age.

Once scarlet fever was considered as a deadly childhood fever now a days due to continuous medical research and modernization of medicine treatment has improved significantly,especially after the  discovery of antibiotics.

If left untreated, scarlet fever in more serious conditions can affect the heart, kidneys and other parts of the body.

The signs and symptoms of scarlet fever resemble its name, which are as follows:  

• Red rash-which feels like sand paper and appears like sunburn. Typically it begins on the face and neck and gradually spreads to  trunk, arms and legs. Rash turns pale when pressure is applied on it.
• Red lines- folds of the skin around the groin, armpits, elbows, knees, and neck usually become deeper red than the surrounding rash.
• Flushed face- appearance of a pale ring around the mouth makes face look like its flushed and the rash appears in the shape of butterfly.

These signs and symptoms often persist for a week.

Other signs and symptoms may include:

• fever (38.3 C) or higher with chills.
• sore and red throat sometimes with white or yellowish patches,
• difficulty in swallowing,
• nausea or vomiting,
• enlarged lymph nodes in the neck often tender to touch.

Bacterial intoxication is the main cause of scarlet fever. This bacterium releases a toxin which damages the human tissues and gives the typical appearance of scarlet fever rash and red glossy tongue.

The infection spreads from person to person by the means of droplets expelled from an infected person during coughing or sneezing. Incubation period(the time required for the bacteria to grow in number but not show any typical symptoms) is usually from two to four days.

Diagnosis of scarlet fever starts with physical examination that includes:

• Checking the condition of throat, tonsils and tongue.
• Palpating and checking for the enlarged lymph nodes.
• Accessing the features of rash.
• Throat swab: if strep throat is suspected in such case swab from the throat can be taken and sent for lab diagnosis.

Tests to diagnose the strep bacteria are important because a number of conditions can cause similar signs and symptoms but require different treatments.

If there are no traces of strep bacteria, then most probably some other bacteria are involved.

Antibiotics are the first line treatment for scarlet fever. Course of the medication must be completed.

If the course was not completed according to the prescription, then there are higher chances of reoccurrence and further complications such as systemic toxicity.

Proper hygienic conditions must be maintained in order to prevent scarlet fever. The following steps must be followed:

• Washing hands- washing hands thoroughly for two minutes before and after eating food and using toilet with warm soapy water.
• Sharing food- don’t share dining utensils and food with other children in school.
• Protecting airways- as this fever spreads through airways, using a mask while in contact with infected people may help.  

The following alternative remedies may be tried to reduce the discomfort and pain caused by scarlet fever:  

• Gargling with salt water- gargling with salt water may reduce the pain caused by scarlet fever.  
• Usage of NSAIDS-  these drugs can cure five common symptoms of inflammation:
  • temperature,
  • swelling,
  • redness,
  • pain,
  • loss of function.
• Lozenges – lozenges can reduce the symptoms of sore throat. Such home remedies are well known and frequently used.

Some lifestyle changes can be made to make faster recovery from scarlet fever infection. They include:

• Provide adequate fluids- plenty of fluids must be given to keep the throat moist and prevent dehydration.
• Humidify the air- usage of humidifiers will help to keep the throat moist.  
• Comfortable foods- foods such as soups which has warm liquid in it can help to soothe the throat.
• Avoid irritants- avoid smoking and stay away from home cleaning chemicals which contain acidic fumes and may harm throat. 

There are several risks and complications associated with scarlet fever. Risks include:

• Age of human being usually children from 5- 15 years are more likely to get infected with this disease because their immune system is not fully matured to fight against infections.
• Lack of awareness- without the knowledge about the ways of transmission of this disease, a child tends to be infected more frequently than adults.
• Family members and people who are in close contact with the infected person is at high risk.

Complications of scarlet fever can become prevalent if the treatment was neglected, they include spreading of infection to:

• Tonsils,
• lungs,
• skin,
• kidneys,
• blood,
• middle ear.

Rarely, rheumatic fever, which can infect the heart, joints, nervous system, skin can be a complication of scarlet fever.