Makindo Medical Notes

The presence of coryzal symptoms, cough or diarrhoea, make a diagnosis of scarlet fever unlikely. People can be infectious for two to three weeks after the symptoms appear unless they are treated

About

• Scarlet fever is mainly a childhood disease
• Most commonly seen between the ages of 2 and 8 years

Aetiology

• Caused by toxin-producing strains of Streptococcus pyogenes (Group A streptococcus, or GAS)
• Scarlet fever, is highly contagious and is spread by close contact with someone carrying the bacteria.
• It takes around 2 to 5 days to develop symptoms after exposure to these bacteria.

Clinical

• The rash begins with papular lesions on the body that then spread to the neck, arms
• The rash is often accentuated in flexural creases but tends to spare the palms and soles of the feet.
• The rash is not pruritic but has a characteristic sand-paper feel to it.
• Associated symptoms include: Sore throat/tonsillitis, Fever
• Painful cervical lymphadenopathy, Strawberry tongue

Complications

• Rarely, invasive group A streptococcal infections such as meningitis, pneumonia, and septic arthritis develop

Differentials

Investigations

Management

• Prevention: Scarlet fever is spread via the mucus and saliva of infected people. It can also be caught from any drinking glasses, plates or utensils they have used. To protect yourself from getting the illness you should: wash your hands often, not share eating utensils with an infected person, wash, or dispose of, handkerchiefs and tissues contaminated by an infected person, be aware that you can catch scarlet fever by inhaling contaminated airborne droplets if someone with the illness coughs or sneezes in the air near you
• Actions: If you think you, or your child, have scarlet fever: See your GP. Make sure that you or your child take(s) the full course of any antibiotics prescribed. Although you or your child will feel better soon after starting the course of antibiotics, you must complete the course to ensure that you do not carry the bacteria in your throat after you have recovered. Stay at home, away from nursery, school or work for at least 24 hours after starting the antibiotic treatment, to avoid spreading the infection
• Amoxicillin
• Penicillin V
• Azithromycin

References

Revisions