From the Guidelines
Scarlet fever is a bacterial infection caused by group A Streptococcus bacteria, characterized by a distinctive bright red rash, high fever, sore throat, and a strawberry-like appearance of the tongue. This condition typically affects children between 5 and 15 years old. The infection is spread through respiratory droplets and direct contact, emphasizing the importance of infected individuals staying home from school or work for at least 24 hours after starting antibiotics 1.
Key Characteristics and Treatment
- The bright red rash, which feels like sandpaper, usually begins on the neck and chest before spreading to the rest of the body.
- A high fever and sore throat are common symptoms.
- The tongue may have a strawberry-like appearance.
- Treatment involves a full course of antibiotics, such as penicillin or amoxicillin for 10 days, to prevent complications like rheumatic fever, kidney inflammation, and ear infections 1.
- For individuals with penicillin allergies, alternatives like clindamycin or azithromycin can be used.
Importance of Proper Treatment
Completing the entire antibiotic course is crucial, even if symptoms improve, to prevent serious complications. The bacteria produce toxins that cause blood vessels in the skin to dilate, creating the characteristic red rash. Without proper treatment, the infection can lead to severe health issues, making timely and appropriate antibiotic therapy essential 1.
From the Research
Definition and Causes of Scarlet Fever
- Scarlet fever is an infectious disease caused by group A streptococcal bacteria, transmitted mainly through direct contact with the saliva and nasal fluids of infected people 2.
- It may also arise from streptococcal wound infections or burns 2.
- The disease is related to the streptococcal erythrogenic toxins 3.
Symptoms and Characteristics
- Scarlet fever manifests as a sore throat, fever, and a sandpaper-like, papular skin rash 2.
- The disease most commonly affects children aged 5-15 years 2.
- The skin rash can have an atypical distribution, making diagnosis challenging 4.
- Patients with Down syndrome are predisposed to bacterial respiratory diseases, including scarlet fever, which can have a prolonged and complicated course 5.
Diagnosis and Treatment
- Early diagnosis and treatment of scarlet fever are essential to reduce the risk of developing local and systemic complications, such as acute rheumatic fever, glomerulonephritis, bacteremia, pneumonia, endocarditis, and meningitis 2.
- A high degree of suspicion is required to diagnose scarlet fever, especially in cases with atypical presentations 4.
- Patients with scarlet fever should be treated with antibiotics, and hospitalization may be necessary in severe cases 5.
Complications and Epidemiology
- Scarlet fever can lead to severe complications, such as pneumonia, especially in patients with underlying conditions like Down syndrome 5.
- The disease can have a significant impact on public health, as seen in the 2011 epidemic in Beijing, China, where a peak monthly incidence rate 2.9-6.7 times higher than previous years was reported 6.
- The epidemiology of scarlet fever can vary by region, with different strains of group A Streptococcus circulating in different areas 6.