Scarlet fever


Scarlet fever

Description of scarlet fever

The traditional name of the disease comes from its typical symptom called. Špalová rash (rash spálového). There are two types of scarlet fever, and it Špálova angina, where the rash is followed by a short timeframe for symptoms of tonsillitis, scarlet fever and the wound where the bacteria penetrated into the body injury, which means that the symptoms of angina may not occur. If yes, then occur after the onset of rash. Both types have a common originator scarlet fever, which is a Streptococcuspyogenes.

Špálova angina, for which the following text aims, usually affects children under the age of twelve and older than four years. A disease of older or younger people is not excluded, but is not common. In infants younger than 5 months, the disease does not occur at all.

Before the discovery of penicillin, this disease often fatal or leaving any serious consequences, especially for the heart (heart muscle and valves), kidneys and joints.

At present, the incidence of scarlet fever tends to diminish, deaths it was not in the Czech Republic in the last few years.Relatively easy detection of the disease in the typical symptoms, quick causative agent and especially the excellent efficacy of antibiotics of first choice (penicillin) to pyogenic streptococci are the reason that scarlet fever is not a dreaded disease.

Streptococcus, causative scarlet fever and other diseases

Streptococcus pyogenes bacteria is not exceptional. The source in the environment and therefore the source of infection is the only person, whether the person appearing symptoms or carriers without symptoms.

Carriership strep also is not rare. Especially young people can use as a carrier, but usually only for a short time. Once the carrier body produces antibodies against a specific strain of bacteria carriage ends.

Streptococcus is also able to survive relatively long time in human subjects surrounding (in laundry, dishwashing, but also e.g. dust). Transmission from person to person by droplet is going the way(coughing or sneezing), through the digestive tract (such as the use of contaminated utensils). In the case of the aforementioned early scarlet fever is the entry point of skin damage.

Different strains of streptococci differ in virulence, the ability to be harmful to the human body.Virulence depends primarily on what a particular strain of the bacterial wall structure (cell envelope), ie whether on their surface carries the molecules responsible for the adverse reactions with the tissues of human beings.

It is also essential that own genetic makeup allows the bacteria to form a so-called. Pyrogenic (erytrogenní) toxin. This substance that exists in several versions, is directly responsible for the major symptom of scarlet fever, a rash. This arises both because of damage delicate vasculartoxin for more then due to an immune response that is directed against the toxin. Pyrogenic toxin may in individuals with immune disorders to cause toxic shock, which is a serious, life threatening condition characterized by impaired blood circulation and subsequent potential mnohoorgánovým failure.

A streptococci produce a number of other substances that facilitate the spread of infection in the body and create an ideal environment for life and reproduction of bacteria. Considerable variability in structure and streptococcal virulence strains is why, in addition to scarlet streptococci can induce numerous other diseases (e.g. impetigo, simple streptococcal tonsillitis etc.).

Untreated streptococcal infections threatens emergence postreptokokových sterile consequences, which are separate diseases in which, however, streptococcus is present in the body. These include serious inflammation of the kidneys, rheumatic fever, and disorders of the nervous system (developed in a period of weeks with a history of streptococcal infection). That for the formation of these diseases is originally streptococcal infections, it is inferred by increased levels of antibodies against ‘. Streptolysin O, proteinaceous product streptococci, which remain in the blood longer maintained. This test is known as ASO (anti-streptolysin O).

Immunity against streptococcus

After antecedent streptococcal disease is the human remains immune to the strain that caused the disease. Given the already indicated, there are many variants of Streptococcus is possible ill streptococcal disease again but another strain against which the antibody has no body.

Pyrogenic toxins are also present in several types. If one gets sick person burns, remains immune to the toxin that caused it. Streptococcal infection producing another type of toxin may cause scarlet fever again.

Vaccination against Streptococcus pyogenes can not be done just for the large number of existing strains. An effective vaccine would have to include all of these strains, which is currently impossible.

 

Risk factors and prevention possibilities scarlet fever

A risk factor is age, or about 4-10 years and seasons (winter and spring).

Given the above findings on the prevalence of strep prevention options are limited. In connection with the relatively large amount of Chronic carriers can only hope for good hygiene habits in society (covering the mouth when coughing and sneezing), children can infect the division of food and beverages or from contaminated dust or toys, because here is an important lesson about frequent handwashing. Vaccination does not exist.

Sick child must be immediately withdrawn from the children’s teams. When it comes to groups of preschool children, then these should be after eight consecutive days monitored by a doctor. In the case of multiple occurrence of scarlet fever in the group can still be healthy subjects administered a single penicillin with long-term effect.

Persons with whom the patient was in contact swab is taken and tested for the presence of streptococcus. If the examination is positive, they must also submit those persons to antibiotic treatment. Children with a family with scarlet fever occurred, not after a period of eight days from the occurrence of the disease to attend a children’s team. Cases of scarlet fever in the Czech Republic are subject to mandatory reporting.

 

Signs and symptoms of scarlet fever

If bacteria enter into the body through the mouth, then after a short incubation time long one to five days to develop symptoms of angina, evolving very fast.

First, it aches accompanied by headaches often occur even abdominal pain and vomiting. The patient has fever and chills. Swallowing is painful when looking into the throat we see characteristic changes, such as coatings and pins almonds, small spots on the floor. Language is at first whitish-furred, after about 2 days, the disease begins to peel, the color changes to a deep red and the surface acquires an appearance similar to raspberry (raspberry language).

Palpation of the neck can detect enlarged hard nodules that are painful on palpation. They can cause pain even at the mere movement of the neck. The faces are red patient ( “fire”), the skin around the mouth is contrary faded. The eyes are shiny.

Špálova rash usually has the form of a pale red dots, but may only occur as skin rougheningapparent on palpation (no color). It occurs frequently in the typical sequence: first the abdomen, then the chest and these sites are spreading to other places (inner thighs, underarms, my elbow). In the folds of the skin rash seen forming lines (výsevové line). Around the nails and on the earlobes can be seen pale buds. Rash after pressure to the skin loses its color. The patient may complain ofitching, restless and scratching.

The rash fades in about four days. Skin rash after rohovatí and peels off. The degree of exfoliation depends on the severity of the scarlet fever. Completely absent, but may also have the form of exfoliating the skin to shreds, which is evident for a long time (even weeks) after the disappearance of other symptoms.

 

Examination and treatment of scarlet fever

The doctor is required when a suspected scarlet fever go as soon as possible. Physician diagnosis determined by the typical symptoms. To confirm the diagnosis takes a throat swab sample for microbiological examination. Given that the result is not immediately available, the doctor can also determine the orientation presence of streptococcus using a test kit at the office.

The collected blood is determined biochemical laboratory signs of inflammation (especially so. CRP, whose elevated levels can point to a bacterial examination before they are fully developed visible symptoms).

After the examination the doctor puts penicillin antibiotic. It is not yet known strain of Streptococcus pyogenes, which would be resistant to penicillin and treatment gives excellent results during 2-3 days. For more severe forms of scarlet fever patient is hospitalized and antibiotics are administered by injection. Usually, however, possible to keep the patient at home. In tablets, penicillin administered for 10 days, then administering yet known. Depot penicillin whose prolonged effective level in the body prevents relapse.

When unpleasant itching doctor can prescribe also a reliever inhaler (antihistamine). The temperature is treated with paracetamol, ibuprofen or a combination thereof, which advises the doctor. It is possible to apply cold packs.

 

How can I help myself

We see to it that the child abide by bed rest, at least one week. In the first few days, the patient can infect family members, in accordance with the above findings on the spread of streptococcus will prevent contact with siblings, the patient uses their own dishes and towel. After treatment, bed linen, towels and dishes hygienically osetrime well.

Serve the sick enough fluids. Sore throat gargle can moderate, which can be bought at the pharmacy. Sick may be due to a sore throat and fatigue, decreased appetite, which we respect.

Even after therapy is sick tired, it is necessary to take a longer recovery time (about one week after discontinuation of treatment with antibiotics).

 

The complications of scarlet fever

When the timely initiation of treatment are not common. Inflammation may spread e.g. into the nasal cavity, middle ear, but also to bone and elsewhere.

After stopping treatment usually urine is investigating whether there is inflammation of the kidneys. Treatment of kidney infection is long-term, adverse circumstances, inflammation can go into a chronic form, which is essentially a permanent result.

When untreated streptococcal diseases arise damage to the heart muscle, valves, joints and also disorders of the nervous activity, therefore it is always necessary each streptococcal tonsillitis, scarlet fever not sufficiently přeléčit antibiotics (see. Above sterile consequences). Consequences of untreated infection will be felt in the next few weeks.

Other names: scarlatina, skarlatina, scorching angina, early scarlet fever, scarlet fever

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