Scarlet fever: causes, symptoms, diagnosis, course therapy

Sudden fever, red cheeks and tonsillitis: these symptoms indicate the infectious disease scarlet fever. A little later the typical rash and the so-called strawberry tongue appear. Babies and school-age children are particularly often affected. But almost everyone can get infected with scarlet fever. Our expert Dr. Titus Brinker, dermatologist from Heidelberg, explains what those affected need to know about the contagious disease and its treatment options. You can consult dermatologists from Heidelberg individually on our homepage.

Two classic scarlet fever symptoms: paleness around the mouth (perioral) & strawberry tongue.

Infectious disease scarlet fever – a short profile

Scarlet fever is one of the infectious diseases. It is considered a typical childhood disease, since children are most often affected. However, people of all ages can become infected. About 1 to 1.5 million cases occur each year. The cause of the disease are bacteria that belong to the A streptococci. Your metabolism produces poisons (scarlet fever toxins), which are responsible for the symptoms of the disease. The most common symptoms are severe swallowing, inflamed tonsils, rash and high fever. Vaccination against scarlet fever is not possible because there are too many variants of the pathogen. For this reason, those affected after an illness are not immune to being infected with another scarlet fever. If you suspect an infection with A streptococcus, it is important to go to the doctor immediately. He can make the right diagnosis with a physical exam, a scarlet fever test, or a lab test for a throat swab.

The main transmission routes for scarlet fever

Scarlet fever is transmitted from person to person. Infection is particularly common due to the smallest droplets of liquid that get into the environment when coughing or sneezing (droplet infection). These droplets contain the pathogens. Whoever inhales them can become infected with scarlet fever. Objects and objects that are touched by scarlet fever patients are other ways of infection. The streptococci usually invade about the mucous membranes of the mouth and nose, less often over open skin wounds (scarlet fever).

Symptoms and course of scarlet fever

Patients who have contracted the pathogen usually show the first symptoms after one to three days. There are a number of typical scarlet fever symptoms that occur in many patients. In some cases, signs of illness are missing or are only weakly pronounced.

At the onset of the disease, symptoms may resemble those of other infectious diseases. Chills, fatigue, sore throat and headache seem to indicate flu. The fever then rises rapidly and the lymph nodes swell on the neck. The inflammation in the throat and throat increases. In some cases, white coating forms on the tonsils and tongue. The cheeks are very red. Other possible symptoms include severe abdominal pain and vomiting.

The rash (rash) typical of scarlet fever is visible after a day or two. The light red, small spots initially form in the armpit and groin area and on the chest. In the following days, the scarlet rash spreads over the body. The mouth-chin triangle, palms and soles of the feet are left out. The rash does not itch and fades for a short time when pressure is applied to one area. The so-called strawberry or raspberry tongue is also typical for scarlet fever. It is bright red and looks like a berry because of the swollen taste papillae.

About six to nine days after being infected with scarlet fever, the rash subsides and fades. Then the skin begins to peel off. It peels particularly strongly in the area of ​​the palms and soles of the feet. This phase can last up to two months.

Scarlet fever and complications – possible complications of the infectious disease

If the scarlet fever diagnosis is correct and timely, the disease will in most cases be without major complications. antibiotics and the The body’s immune system prevents the pathogens from spreading too much. In some cases, however, the streptococci get into other organs and can, for example, cause purulent tonsillitis, otitis media or sinus infections. Inflammation of the lungs or heart muscle is one of the serious consequences of scarlet fever. In a small number of patients, the organism reacts so strongly to the streptococcal poisons that a toxic shock is triggered. In this case, an emergency doctor must be called immediately. Some secondary diseases occur with a delay. Acute rheumatic fever (ARF) attacks body tissues and occurs about two to three weeks after the first symptoms of scarlet fever. Acute kidney infections are also possible during this period.

Scarlet fever infection risk: How long are patients contagious?

As long as the streptococci are active, they can be passed on. With antibiotic treatment, there is no longer any risk of infection around 24 hours after the first dose. Without antibiotic therapy, most patients are contagious for about three weeks, some even longer. Scarlet fever is also possible in people who carry the pathogen but do not show any symptoms.

Correctly treating scarlet fever: the most important therapeutic options

Scarlet fever therapy consists of fighting the pathogens and alleviating the symptoms of the disease. The A streptococci that trigger scarlet fever respond to a suitable antibiotic. The drugs are available in different dosage forms. As a rule, tablets are prescribed. Juice antibiotics have proven effective in younger children. The doctor or pediatrician decides which active ingredient and in which form is best suited for a particular patient.

A wide range of treatment options are available for symptom relief. It is crucial that they are adapted to the severity of the symptoms and the age of the patient. Fever can be reduced with the appropriate active ingredients. It should be noted that younger children are not allowed to take common active ingredients such as acetylsalicylic acid. Home remedies such as calf wraps can be useful in lighter cases. For example, garlic solutions and lozenges help against sore throat and difficulty swallowing.

Who can get scarlet fever??

Scarlet fever is possible at any age. Infants are least affected because they are protected by antibodies from the mother shortly after birth. Children between the ages of six and twelve are most often affected. Infectious disease is not as common in adults as it is in school. The scarlet fever symptoms in adult Patients are no different from the symptoms in children. However, the correct diagnosis can be delayed. When the first signs appear, adults mostly don’t think of the childhood disease scarlet fever and suspect a flu-like infection. Because of this, there is a higher risk of complications or late complications.

Important tips for scarlet fever treatment

Those who have contracted scarlet fever can do a lot to get well as quickly as possible. Bed rest and adequate hydration help the body cope with the disease. The medications prescribed by the doctor must be taken exactly as directed to avoid complications or relapses. This applies in particular to antibiotics. Self-medication without consulting the doctor in charge is not recommended due to possible interactions.

During the infection period, patients should have as little contact with others as possible in order to avoid spreading the pathogen. Hygiene measures such as regular hand washing and immediate disposal of handkerchiefs are important. Sick people may not visit community facilities such as schools, after-school care centers or daycare centers during the contagion period. In some federal states, there is an obligation to report scarlet fever.

Prevention and protection: How can scarlet fever be avoided? >There is no preventive vaccination like for flu with scarlet fever. Even a cured scarlet fever is not sufficient protection, since patients can become ill again with another variant of the scarlet fever. The most effective known anti-streptococcal agent is antibiotics. As a preventive measure, however, they are only used in exceptional cases, such as for people with immunodeficiency or serious underlying diseases. The best way to prevent scarlet fever is to avoid contact with the sick. Careful hygiene and regular hand washing with soap are other effective measures to reduce the risk of infection.

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