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SCARLET FEVER

DESCRIPTION

Scarlet fever is a childhood disorder characterized by a bright red rash. Scarlet fever is preceded by a streptococcal throat infection. Both are very contagious. The throat, tonsils, and skin are involved. Scarlet fever can affect children and adolescents, especially between ages 2 and 10.
Appropriate health care includes:
  • Home care after diagnosis.
  • Physician's monitoring of general condition and medications.

    SIGNS & SYMPTOMS
    Symptoms may vary. Following is the usual course of the disease:

  • Day 1--Fever as high as 104F (40C), a red sore throat, swollen tonsils (tonsils may have a whitish coating), enlarged lymph glands in the neck, a cough, and vomiting.
  • Day 2--Bright red rash on the child's face, except around the mouth.
  • Day 3--Reddened tongue and rash in body creases, spreading to the neck, chest and back, then to the entire body. The rash resembles a sunburn with bumps.
  • Day 6--Faded rash and skin that begins peeling, continuing for 10 to 14 days.

    CAUSES
    Strep infection caused by a specific type of strep germ that manufactures a scarlet-fever toxin (poison). Not all strep infections cause scarlet fever, because not everyone is susceptible to the rash-producing toxin. In one family, one child may contract scarlet fever, another may have a strep throat only, and a third may carry the germ and transmit it to others without being sick.

    RISK FACTORS
    Family history of recurrent strep infections, recent impetigo, crowded or unsanitary living conditions, and exposure to others in public places.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Cannot be prevented completely, because some healthy children are carriers of the strep germ without being ill. However, partial preventive measures include:
  • Antibiotic treatment for at least 10 days for any strep infection.
  • Avoidance of persons with sore throats.

    BASIC INFORMATION

    MEDICAL TESTS

    Your own observation of symptoms; medical history and physical exam by a doctor; laboratory throat culture.

    POSSIBLE COMPLICATIONS

    Without treatment: rheumatic fever; impaired hearing; glomerulonephritis; meningitis; pneumonia; encephalitis.

    PROBABLE OUTCOME
    Usually curable in 10 days or more with treatment. Scarlet fever is not as prevalent as it once was, and it is rarely fatal. With antibiotic treatment, the severity and likelihood of complications decrease.

    TREATMENT

    HOME CARE

  • Prepare a soothing tea gargle for a child old enough to gargle. Double the usual strength of tea. This may be gargled warm or cold as often as it feels soothing to your child.
  • Use a cool-mist humidifier to relieve the dry, tight feeling in the child's throat.
  • Use moist, warm soaks to relieve tender, enlarged glands in the child's neck.
  • Isolate the ill child from other people, including family members.

    MEDICATION
    Your doctor may prescribe penicillin to shorten the course of scarlet fever and prevent complications. If your child is allergic to penicillin, other antibiotics, such as erythromycin, are also effective.

    ACTIVITY
    Bed rest is necessary until all signs of illness have disappeared. Your child may read or watch TV.

    DIET & FLUIDS
    No special diet.

    OK TO GO TO SCHOOL?

    When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of strep throat or scarlet fever.
  • The following occurs during treatment: --Temperature becomes normal for 2 days, then rises over 101F (38.3C). --New symptoms begin such as nausea; vomiting; earache; cough; headache; thick, colored, nasal drainage; chest pain; or labored breathing. ‡
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