What is ‘scarlet fever’?
Scarlet fever is the term given to the febrile illness that consists of a characteristic rash secondary to the release of exotoxins by the bacteria, Streptococcus pyogenes. The disease would no longer be a cause of fatalities as the most dreadful complications are prevented through appropriate initial treatment that is in existence.
What are the symptoms and signs of ‘scarlet fever’?
The infection begins with a fever and in certain instances, the fever could be more than 101 F degrees but, in other instances, it can also be a mild fever as well. Then the patient might develop a sore throat with enlarged tonsils or else tonsils covered in white exudates. At the same time, the tongue may become coated and might show a furry white appearance.
After few days from developing the fever and sore throat, the patient can show the characteristic appearance of the scarlet fever rash. The rash will have a fine and red appearance with rough textured feeling when palpated. It can also blanched on palpation which means upon touching it will either disappear or will become pale than what it was used to. The rash usually appears in the chest, arm pits and behind the ears and thereafter it can spread to other parts of the body including the inside of the throat and covering the uvula. It would be possible to note a bright red tongue known as the ‘strawberry tongue’ in patients who have progressed to this stage of the illness.
At times the rash could be feeling itchy and it will start to subside after few days. But, at the same time while it is subsiding, the skin which is affected will start to peel off.
Another important characteristic in the rash would be its relative sparing of the face, specially the area which is surrounding the mouth (Circum oral).
Apart from these symptoms, there can be enlarged lymph nodes, especially in the cervical area and the patient will also complain of body aches, loss of appetite and other such symptoms as well.
How is it treated?
When considering the available treatment options, it is imperative to start antibiotics as early as possible and the first line of treatment would be oral penicillin’s continued for 10 days if the patient is not allergic to these drugs. If there is an allergy, they can be started on antibiotics such as erythromycin and clindamycin. The patient will not be infective after one or two days following the initiation of antibiotic treatment and other supportive measures include maintaining hydration, reducing the itching with antihistamine medications as well as antipyretics to reduce the fever can be administered.
If a person is suspected to be exposed to a patient with scarlet fever, especially if that person is from 3 years to young adulthood, doing a culture of the throat for streptococcus and starting on empirical antibiotics as soon as possible with the culture findings would be a prudent option.