The Symptoms of scarlet fever in children and adults.
Scarlet fever is called acute infection, peculiar only to human disease. Typical manifestations of scarlet fever are intoxication, inflammation of the oropharyngeal area and punctate skin rash (exanthema).
The causes of scarlet fever in adults and children
As the infectious agent, acts streptococcal bacterium belonging to the group A (S. Pyogenes). This Streptococcus is the cause of other serious infections: sore throats and tonsillitis chronic type. rheumatic phenomena, erysipelas, skin diseases (streptococcal), renal disease (glomerular nephritis), etc. there is scarlet fever in children and adults – despite the common misconception that it is a disease “children”.
Carrier and distributor of infection is a man: suffering from any clinical form of streptococcal infections that affect the respiratory tract (respiratory), or latent carrier of the bacteria S. Pyogenes.
Scarlet fever is transmitted by airborne droplets (aerosol mechanism); as a rule, necessary for infection prolonged and close contact with a carrier of infection. Also possible contact method of infection, if not careful treatment of the hands and household items, or nutritional – consumption of food contaminated with bacteria.
Clinical symptoms of scarlet fever
When scarlet fever incubation period varies widely: from 24 hours to 10 days. Most often the disease begins acutely, in the first hours abruptly jumps body temperature (up to the critical value), the patient is experiencing severe malaise, weakness, complains of a headache. Marked increase of heart rate (tachycardia ), sometimes there is pain in the abdomen. In the period of initial febrile state, some people get excited with signs of euphoria and actively moving; others become apathetic, lethargic, constantly sleepy. Due to severe intoxication quite often there is vomiting. However, it should be noted that in our days scarlet fever in children, as in adults, can occur on the background of subfebrile temperature.
Another characteristic feature of this disease is pain in throat when swallowing movements. Upon visual examination, the physician notes “flaming Zev”: strong, extensive redness of the tonsils, Palatine arches and the uvula, palate (soft palate), as well as in the pharynx posterior wall – typical symptoms of scarlet fever. Hyperemia with scarlet fever are expressed much more clearly than is the case when the diagnosis of “catarrhal sore throat”; the distinguishing feature also serves as a clear boundary redness, taking place at the place of junction of the mucosa and hard palate. Sometimes the tonsils, bright red and friable, can appear raids: mucopurulent, croupous, in severe cases, necrotic type; they have the appearance of small localized lesions, rarely coalesce into extensive areas of the lesion.
At the same time is the development of lymphadenitis (regional type); upon examination, digital examination of the density and tenderness of the lymph nodes perenesenko Department. In the first days of the disease the tongue of the patient covered with a touch of grayish-white color, and the fourth-the fifth day becomes pure, it becomes crimson color and a pronounced hypertrophy of the papillae. If the disease is especially hard, crimson hue acquire and lips of the patient. During this period, the symptoms of scarlet fever, similar to anginal, are declining; the slowest are the raids necrotic character in the oropharynx. Under the control of the cardiovascular system, there is a slight increase of arterial blood pressure and rapid heart rate.
Skin rashes usually appear in the first or second day of the disease; rash occurs on the background of the General redness. The existence of such rashes – the typical symptoms of scarlet fever in children and adults, are important for proper diagnosis of the disease. First of all, the rashes occur on face, neck, upper trunk; then affects the limbs in the region of the bend, the rash appears on the sides of the abdomen and chest, on the inner side of the thigh. Often when pressed on the skin remains white spot is a manifestation of the so-called white dermographism. The characteristic symptom of scarlet fever, Pastie: merger rash in stripes of dark red colour in places groin, elbow, knee creases, armpits. Solid erythema (merger of small lesions in single lesions) can also be observed in other places. Of facial rashes focus in the cheeks, a little whiskey and capture the forehead, leaving free the nasolabial triangle. This zone, on the contrary, is characterized by a pale – according to the symptom Filatov. It is also noted, and “symptom of the palm”: if on skin rash pressure hand erythema in this area for some time disappears.
As the symptoms of scarlet fever, consider the traces punctate hemorrhages on the folds of the extremities caused by excessive fragility of blood vessels; such hemorrhages occur where the skin compresses or rubs tight clothes, uncomfortable bed. Marked positive symptoms endothelial groups: tourniquet (or symptom Konchalovsky-Tiller-Leede, when the tightening strap forearm vascular fragility is manifested by petechial rashes in the pit of the elbow bend) and gum (“effacement” of the veins).
Rash with scarlet fever may occur immediately, but only for 3-4 days, and may be absent altogether. Sometimes typical scarlet rash is accompanied by small papules and vesicles.
On the third to fifth day, the symptoms of scarlet fever in children begin to disappear, there is a gradual Palen temperature, pallor and disappearance of the rash; in adults also, if there are no serious complications. A week after the onset of the disease or later instead of the rash there is the effect of peeling skin: mostly melkočešujčatye, only on the soles and palms, the skin coming off in large plates.
How intensively are signs of scarlet fever rashes and how fast they are – depends on the individual case of the disease. It happens that a small skin rashes disappear within a few hours after occurrence – it happens in milder forms of scarlet fever. Than heavier rash, the stronger and longer then flaking skin.
According to the clinical picture, scarlet fever in children and adults is negligible, what can be said about the severity of the disease.
Form of scarlet fever
Ekstrabukkalnaya form. Today is rare. Fast-growing scarlet fever: incubation period is shortened, the disease begins at the moment of penetration of the pathogen into the body through the affected area of the skin – wounds, burns, erosion caused by streptoderma. Typical symptoms of this form of propagation is scarlet rash from the place of introduction of infection, and the absence of inflammatory processes in the throat and lymph nodes in the neck.
A subtle form. Common among adult patients. Signs of scarlet fever this form: General intoxication of the organism is weak, pale scanty rash appears for a short period, lesions of the oropharynx are of a catarrhal character.
Severe (toxic-septic). Experiencing this scarlet fever in adults. In this case, the disease begins rapidly, with a high body temperature and rapid increase in symptoms of cardiovascular disease. In patients with marked voiceless heart tones, blood pressure falls, the pulse becomes thready, hands and legs feel cold. Commonly observed symptoms of scarlet fever in a severe form, as skin hemorrhages (hemmorage). During the next few days to an underlying disease added complicating factors: disturbances of the heart, kidneys, lesions of the joints (infectious-allergic complications); necrotic tonsillitis, otitis media. inflammation of the lymph nodes (septic complications).
Scarlet fever: complications
When scarlet fever in children complications – inflammation of the lymph nodes (lymphadenitis) necrotizing or suppurative type, acute purulent otitis (ear inflammation). Usually, scarlet fever occurs in adults is much harder than in patients in childhood. The disease is complicated by inflammatory processes in the kidney glomeruli (diffuse glomerulonephritis), abnormalities of the heart muscle (myocarditis) and other violations of the infectious-allergic origin.
Treatment of scarlet fever
Before in medical practice included antibiotics, scarlet fever was considered a severe, often fatal illness. Today she is treated at home – of course, if it’s not heavy or complicated shape. The patient is prescribed stay in bed during the week and a half, and a 10-day course of antibiotics.
Patients with scarlet fever should rinse the oropharynx with a special solution, with infusions of medicinal herbs (eucalyptus, chamomile, calendula). Recommended restorative vitamins and antiallergen in a standard dosage.