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Scarlet fever in children: symptoms and treatment, prevention

What it is? Scarlet fever in children is a childhood disease that belongs to the class of bacterial infections. It is characterized by inflammatory processes in the lymphoid tissue of the palatine tonsils, nonspecific disturbances in the system of thermoregulation of the body and intoxication syndrome, and abundant skin rash on areas of the body and face (see photo).

The disease is caused by a pathogen belonging to the classification of beta hemolytic bacteria of the Streptococcus class, which is distinguished by its great aggressiveness. Once inside the body produces very poisonous erythrotoxins, nicknamed in medicine "red poison". The consequence of the impact is inherent only in this class of streptococcus and is due to pathological processes that change mucous and skin.

The first description of the disease dates back to 1675. The English doctor Thomas Sydenham described the detailed symptoms of scarlet fever, but he called the disease purple purge. And only with time, they began to call her by the beautiful name “Scarlet” (scarlet) scarlet fever, which means scarlet or red.

Scarlet fever in children photo

Scarlet fever in children photo

Children under the age of 16 are susceptible to the disease - infants and one-year-old babies are ill very rarely. The disease is transmitted to the most rapid and common of all ways of infection - airborne. Especially dangerous is an infected child in the early days of the disease.

The bacterium is capable of maintaining activity in the environment for a very long time, therefore, all objects with which the patient has been in contact can be infectious. The carriers can be perfectly healthy children, but are carriers of the pathogen.

The incubation period for scarlet fever varies from 2 days to 7 days, depending on the child's well-being for the period of infection - the presence of acute respiratory infections or ENT pathologies, signs of hypothermia. The period of latency can be extended to two weeks. For example, in the period of any disease in the treatment of which antibiotic drugs are used.


Signs of scarlet fever in a child, rash

Signs of scarlet fever in a child

Symptoms of scarlet fever in children and clinical signs depend on the form of its manifestation:

  1. Foringal or extrapharyngeal, each of which can occur with pronounced symptoms (typical form) and a hidden form (atypical).
  2. Infectious process of typical scarlet fever can be expressed in mild, moderate and severe form of the course, which in turn can manifest itself with the predominance of separately expressed components - toxic, septic, or mixed (toxic-septic).
  3. The atypical form of the infection is characterized by a "blurry" (subklenicheskim) and residual (rudimentary) manifestation.

The general nature of the symptoms of scarlet fever in children is the onset of the disease in acute form. The first hours are characterized by a rapid rise in temperature to 40 and above. At the same time, there are signs of an effect of infection on the body of toxins - nausea, vomiting, sore throat and sore throat. All this is accompanied by:

  • the deterioration of the child;
  • migraine and weakness;
  • tachycardia and abdominal pain.

At the onset of the disease , high fever can cause excessive excitability, mobility, a sense of euphoria in a child, or vice versa - lethargy, drowsiness and apathy. Literally after some time, the first rash appears on the face and neck, gradually spreading over the body, hands and feet. In some cases, the rash may not appear immediately, but linger for a couple of days.

Symptoms of an infectious rash have their own characteristic, manifested by exanthemous punctate rashes on hyperemic skin. It is more pronounced in the lower abdomen, on the sides of the body, flexion zones of the arms and legs, skin folds - brightly saturated. It may look like fine spots or it merges into continuous erythematous spots.

Very clearly it is expressed on the skin surface of the cheeks - bright red fused rashes look very contrast in comparison with the light skin of the nasolabial triangle, also covered with a punctate rash. Having a finger (slightly pressing on the cheek) you can see a whitish mark in the form of a strip, gradually changing color to the color of the original scarlet brightness (white dermagrophism is a characteristic symptom of the disease).

symptoms of scarlet fever in children

The rash of scarlet fever in children can manifest itself in various ways. Small, small, white tubercles with muddy contents inside (miliary rash), capable of merging and the formation of large bubbles. Frequent localization - hands.

Papular rash, melkopyatnistnoy or hemorrhagic. In the latent form of the disease (atypical), rashes may not be. It all depends on the severity of the pathology and the degree of exposure to streptococcal toxins.

After 5-7 days, the patient feels better, the temperature begins to fall, the rash turns pale and disappears. The process of fine peeling begins in places of tender skin (on the folds, neck, earlobes, groin), consistently spreading to the whole body.

Peeling on the palms and feet is more intense, moving away in large layers. In very young children, desquamation may be completely absent.

Scarlet fever is almost always accompanied by sore throat , as the throat and lymphoid tissue of the tonsils are the main ways of infection. But even if the infection struck the body in another way, the development of angina is guaranteed in 99% of cases. The special difference is due to a limited inflammatory process that does not extend to the mucous membrane of the hard palate, and the completion of the process within a week.

The development of necrotic tonsillitis is accompanied by necrotic foci of gray-green plaque on the tonsil areas. By the end of the 10th day, the state is normalized, but the dryness of the mucous membrane of the mouth remains long, causing constant thirst in the child. When examining the oral cavity, the tongue is coated with a dirty yellow bloom.

On the third day of illness, the plaque shifts to the center and the tongue and acquires a rich scarlet color with crimson swollen papillae. This symptom persists from 7 to 12 days.

Symptoms of scarlet fever in children, photo

Symptoms of scarlet fever in children

symptoms of scarlet fever in young children, photo 4

Easy form

Characterized by moderate subfebrile condition. Intoxication symptoms and rashes are slightly expressed. They are accompanied by catarrhal angina and the main symptoms of the disease for seven days.

Scarlet fever

For a manifestation of the full complex of symptoms, accompanied by severe exanthema, catarrhal or purulent tonsillitis . Symptomatology is characterized by:

  • high fever;
  • malaise and pain in the head;
  • apathy to food and frequent vomiting;
  • heart palpitations;
  • raids and necrosis in the lymphoid tissues of the tonsils;
  • pain when swallowing;
  • profuse scarlet rash.

The disease does not develop further; after a week and a half, the condition and temperature are normalized, the initial symptoms disappear.

Severe toxic, septic and mixed forms

In severe toxic form of the disease, the symptoms manifest as a hyper-hyperthyroid temperature that goes beyond the limits of the thermometer. Patients lose weight greatly, mental disorders are noted, manifesting itself:

  • symptoms of overexcitation, or vice versa, patients are strongly inhibited;
  • severe vomiting, sometimes accompanied by convulsions;
  • meningeal symptoms and neurogenic syncope;
  • persistent increase in blood pressure and tachycardia;
  • elements of hemorrhagic exanthema;
  • catarrhal-purulent angina;
  • manifestations of ITSH (infectious toxic shock).

With pronounced symptoms of toxemia, deep syncope is noted - the scarlet rash turns pale, giving way to bluish skin, cold extremities, and filamentous pulse. With early detection of the disease and adequate treatment, intoxication syndrome is quickly stopped.

The septic form of the disease is added by aseptic components - necrotic phenomena of angina with the spread of necrotic processes from the tissue of the tonsils to the tissue of the soft palate, the mucous membrane of the mouth and nasopharynx. Accompanying development:

  • submandibular lymphadenitis ;
  • periadenitis - inflammation of the tissues adjacent to the lymph nodes;
  • suppuration of lymph nodes - adenophlegmon.

The process of swallowing is accompanied by sharp pain, the child is unable to swallow food and drink. Because of the dryness of the mouth and the tongue of the tongue, cracks appear on the lips. Nose breathing is difficult due to the strong formation of purulent mucous discharge. As a result of the spread of infection from the pharynx, the development of purulent sinusitis and otitis, the manifestation of symptoms of an enlarged heart (scarlet heart) is possible.

Recovery is slow. After a week and a half or on the fourth, due to the development of metastatic abscesses (septicopyemia), or purulent complications, death is possible.

In the mixed form, from the fourth day of the illness, the course is accompanied by mixed severe signs of toxic and septic scarlet fever.

Rapid and hypertoxic form of the disease

Rapid scarlet fever in children fully justifies its name by developing catastrophically quickly, manifesting itself:

  • severe intoxication syndrome;
  • fever with high temperatures;
  • severe mental disorders;
  • fainting and delusional states;
  • profuse vomiting and cramps;
  • tachycardia and coma.

The life of a child immersed in a coma may end in the first days and even hours of illness. Sometimes, against the background of cyanosis of the skin, the main symptoms of scarlet fever are invisible, which contributes to the formulation of a false diagnosis.

Hypertoxic - hemorrhagic variety - a rare disease. Hemorrhagic skin rashes and a rash on mucous membranes join the intoxication syndrome. The combination of such manifestations often leads to death.

Scarlet fever with erased symptoms

Scarlet fever with erased symptoms

This group includes several types of scarlet fever, occurring with the absence of obvious symptoms of the disease, minor signs or their rapid disappearance. Such patients are the most dangerous. Difficult diagnosis contributes to the smooth spread of infection. Therefore, the probability of meeting with the pathology is much higher than how timely it is detected.

According to clinical manifestations, such pathologies of erased forms are subdivided into the type of residual (rudimentary) manifestations, the disease without eruptions, and scarlatinal tonsillitis.

, рудиментарная характеризуется самой легкой клинической картиной. The residual form , rudimentary, is characterized by the easiest clinical picture. The main symptoms are mild. The first two days of the disease may have a slight temperature or remain normal throughout the entire illness.

In the lymph nodes, there may be a slight increase and signs of slight tachycardia, alternating by a decrease in heart rate by the end of the week. Of all the scarlet-like symptoms, the disease can be identified by the condition of the throat, its intense spot redness and moderate pain symptoms when food is swallowed.

Rash on the skin scanty and pale, can be localized only in certain areas - the abdomen and flexion surfaces of the limbs in the form of point hemorrhages. The skin of the nasolabial triangle may be normal or have a slight pallor.

As a rule, scarlet signs disappear quickly. Peeling may be delayed or completely absent. Children who have had this type of disease may later develop complications such as nephritis, otitis, and other diseases.

Scarlet fever without rash

It is characterized by the absence or scant manifestation of the main symptom - rash, but with severe manifestation of all other symptoms, the development of necrotic tonsillitis with early purulent complications.

Extrafaryngal view of the disease

A very rare type of pathology, unlike other forms of scarlet fever in children, infection occurs due to the penetration of the pathogen through the wounds of the skin or mucous integument - trauma, burns, postoperative wounds, during childbirth or in the process of complications with open purulent foci. Such children are not dangerous to others, because they do not emit a pathogen when coughing or sneezing.

The fast latent period (several hours, days) complicates timely diagnostics. Clinic of the disease has its own characteristics - the absence of signs of tonsillitis, inflammatory reactions and the manifestation of rashes in the areas of penetration of the pathogen.

Clinical signs of scarlet fever in young children

signs of scarlet fever in young children

Little patients and infants are prone to manifestations of a septic type of disease, but the intoxication syndrome is mild. In some cases, the disease occurs with a slight subfebrile condition, scant signs of sore throat and a pale rash.

But, in other, similar circumstances, it can be expressed by signs of necrotic angina or nasopharyngitis, multiple purulent-necrotic consequences.

Scarlet fever complications

The most serious consequences of scarlet fever suffered by children - in the form of streptococcal sepsis, adenophlegmon and mastoiditis, with the inclusion of etiotropic benzylpenicillin preparations in the treatment program, are practically reduced to zero. Today, it may be:

  • sinusitis or otitis media ;
  • toxic myocarditis, developing at an early stage of the disease;
  • nephritis, manifested in the second week of moderate signs of proteinuria, leukocyturia, erythrocyturia or cylindruria;
  • "Children's" pneumonia and bronchopneumonia;
  • infectious processes in bone tissue and brain.

Early diagnosis of scarlet fever symptoms in children, treatment and prevention, help to prevent more serious complications in time.

Methods of diagnostic examination

For accurate diagnosis of the disease it is necessary to conduct a series of diagnostic examinations.

  1. An extended blood clinic that helps identify the cause — indicators of the ESR reaction, leukocytosis, and neutrophilia confirm or refute the bacterial nature of the infection.
  2. Bacteriological examination confirms the diagnosis, highlighting the pathogen in cultures of mucous secretions from the oropharynx.
  3. The express method is the most promising method that reveals the pathogen antigen in half an hour using a coagglutination reaction.

Scarlet fever treatment in children, prevention

Treatment and prevention of scarlet fever in children

With a light course of scarlet fever in children, treatment is carried out on an outpatient basis. In difficult cases, to avoid possible complications, babies are hospitalized.

Assigned activity restriction regime and a balanced fortified diet with thermal and mechanical processing of food. It should be mild, not contain irritating components and not capable of causing an allergic reaction. The diet is dominated by a milk-vegetable diet.

Drugs of the penicillin group are widely used as drug therapy. Take into account the age dosage and tolerability of a particular drug. The course of treatment for scarlet fever with antibiotics lasts up to 7 days.

In toxic forms with pronounced symptoms of intoxication, antitoxic serum is administered in the first two days. To enhance the protective immune functions, gamma globulin is administered.

When manifestations of complications is carried out therapeutic treatment of the disease, caused by a complication.


Prevention of scarlet fever in children today is not carried out by the method of vaccination. Specific prevention is - gamma-globulin, applied to weakened children, who were in contact with patients with scarlet fever.

If the child was prescribed antibiotics for scarlet fever in a timely manner, the isolation time could last up to 10 days.

The child is discharged from the hospital after stopping all the inflammatory processes in the nasopharynx and the final recovery. Children are allowed into children's institutions after 12 days. In addition, a weekly quarantine is introduced in groups of children in contact with the patient.


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