Scarlet_Fever_Flashcards
What is scarlet fever?
Scarlet fever is a reaction to erythrogenic toxins produced by Group A haemolytic streptococci, typically Streptococcus pyogenes. It commonly affects children aged 2-6 years.
How is scarlet fever transmitted?
Scarlet fever is spread via respiratory droplets or direct contact with nasal or throat discharges, particularly during sneezing and coughing.
What are the typical symptoms of scarlet fever?
Symptoms include fever, malaise, headache, nausea/vomiting, sore throat, ‘strawberry’ tongue, and a ‘sandpaper’ textured rash that starts on the torso and spares palms and soles.
How is scarlet fever diagnosed?
Diagnosis involves a throat swab, but antibiotic treatment should start immediately rather than waiting for results.
What is the management for scarlet fever?
Management includes 10 days of oral penicillin V, or azithromycin for those with a penicillin allergy. Children can return to school 24 hours after commencing antibiotics.
What are possible complications of scarlet fever?
Complications can include otitis media, rheumatic fever, acute glomerulonephritis, and rare invasive complications like bacteraemia and necrotizing fasciitis.
summarise
Scarlet fever
Scarlet fever is a reaction to erythrogenic toxins produced by Group A haemolytic streptococci (usually Streptococcus pyogenes). It is more common in children aged 2 - 6 years with the peak incidence being at 4 years.
Scarlet fever is spread via the respiratory route by inhaling or ingesting respiratory droplets or by direct contact with nose and throat discharges, (especially during sneezing and coughing).
Scarlet fever has an incubation period of 2-4 days and typically presents with:
fever: typically lasts 24 to 48 hours
malaise, headache, nausea/vomiting
sore throat
‘strawberry’ tongue
rash
fine punctate erythema (‘pinhead’) which generally appears first on the torso and spares the palms and soles
children often have a flushed appearance with circumoral pallor. The rash is often more obvious in the flexures
it is often described as having a rough ‘sandpaper’ texture
desquamination occurs later in the course of the illness, particularly around the fingers and toes
Diagnosis
a throat swab is normally taken but antibiotic treatment should be commenced immediately, rather than waiting for the results
Management
oral penicillin V for 10 days
patients who have a penicillin allergy should be given azithromycin
children can return to school 24 hours after commencing antibiotics
scarlet fever is a notifiable disease
Scarlet fever is usually a mild illness but may be complicated by:
otitis media: the most common complication
rheumatic fever: typically occurs 20 days after infection
acute glomerulonephritis: typically occurs 10 days after infection
invasive complications (e.g. bacteraemia, meningitis, necrotizing fasciitis) are rare but may present acutely with life-threatening illness
An unvaccinated 7-year-old girl presents to the GP accompanied by her mother with complaints of fever, lethargy, and a sore throat for the past day. This morning, she developed a new rash. The mother reports that four days ago, the child was in contact with a child displaying similar symptoms to her child.
On examination, the girl has a temperature of 38.8 ºC, red and inflamed tonsils, and a rash with a sandpaper-like texture.
What is the most likely diagnosis?
Kawasaki’s disease
Measles
Parvovirus B19
Rubella
Scarlet fever
Scarlet fever
Scarlet fever is characterised by a sandpaper rash
The most probable diagnosis in this case is Scarlet fever The clinical presentation of a child exhibiting fever, lethargy, sore throat, and a rash with a sandpaper-like texture is characteristic of scarlet fever.
While other conditions may also present with fever and a rash, the distinctive sandpaper-like rash, coupled with a history of contact with a patient exhibiting similar symptoms, strongly points toward scarlet fever as the most likely diagnosis.
Kawasaki’s disease is incorrect as it typically presents with prolonged fever, conjunctivitis, changes in the mucous membranes, swelling of the hands and feet, and a rash. While fever is a common symptom, the sandpaper-like rash and the specific contact history in this case are more suggestive of scarlet fever.
Measles is incorrect as it is characterized by a high fever, cough, runny nose, and a characteristic rash that usually starts on the face and spreads downward. The sandpaper-like rash and the specific contact history are not typical of measles.
Parvovirus B19 is incorrect. It can cause a rash, especially in children. However, the parvovirus B19 rash is typically described as a ‘slapped cheek’ rash and does not exhibit a sandpaper-like texture.
Rubella or German measles is incorrect. It can cause a rash, but it usually starts on the face and spreads down. The sandpaper-like rash and the specific contact history make scarlet fever a more likely diagnosis.
buzz words
fever, lethargy, and sore throat
new rash - sandpaper-like texture.
in contact with a child displaying similar symptoms
fever
red and inflamed tonsils
