Scarlet Fever, Causes, Diagnosis, Treatment, Prevention, Complications

Scarlet Fever, Causes, Diagnosis, Treatment, Prevention, Complications

Scarlet fever or scarlatina is an infectious disease caused by the bacterium Streptococcus pyogenes. This bacterial infection is characterized by the appearance of a red rash on the skin, high fever and sore throat.

Scarlet fever can happen to anyone. However, this bacterial infection tends to affect children aged 5–15 years more often. Scarlet fever needs to be treated quickly and precisely, because if not, dangerous complications can occur, such as pneumonia.

Causes of Scarlet Fever

Scarlet fever is caused by the Streptococcus pyogenes (S. pyogenes) bacteria which can multiply in the tonsils and throat. These bacteria can release toxins that can enter the bloodstream, and then cause fever and red rashes on the skin.

Transmission of S. pyogenes bacteria can occur through splashing of saliva, such as when a patient sneezes or coughs. Transmission can also occur when someone accidentally consumes food or drink from the same plate or glass as the sufferer.

In addition, touching objects that are splashed with the sufferer's saliva can also cause a person to become infected with the bacteria that causes scarlet fever. Bacteria that are on the hands can develop into skin infections or enter the body if the person touches their mouth or nose without washing their hands first.

Risk factors for scarlet fever

As previously explained, scarlet fever can happen to anyone. However, someone with the following conditions is more at risk of experiencing it:

• 5–15 years old
• Have direct contact with a person with scarlet fever, for example at home or at school
• Work or spend a lot of time in crowded places, such as school or child care

Symptoms of Scarlet Fever

Generally, the symptoms of scarlet fever appear 2–4 days after being infected with the bacteria. These symptoms can include:

• High fever with chills
• Red rash almost all over the body
• The face and neck are flushed, but the skin around the lips is pale
• Red lines in the armpits, folds of the elbows, and behind the knees
• The tongue is bright red with small nodules, or what is commonly called a strawberry tongue
• Sore throat, the throat looks red accompanied by white or yellowish spots appearing
• Swollen tonsils
• Swollen lymph nodes in the neck
• Abdominal pain
• Nausea or vomiting
• Difficult to swallow
• Headache

The rash that occurs in patients with scarlet fever is a characteristic symptom. The rash looks like a sunburn and feels rough. The rash usually starts on the face and neck and then spreads all over the body. The rash will appear redder in areas where the skin folds, such as the armpits, elbows and knees.

Usually, the skin rash appears 1–2 days after the fever. However, in certain cases, the rash can occur 2 days before the fever and sore throat appear.

The rash can last for about 1 week. After these symptoms subside, the skin affected by the rash may peel.

When to see a doctor

Check with your doctor if you or your child experience any of the above symptoms, especially after interacting directly with people who have the same symptoms or are known to have scarlet fever. Early examination will speed up diagnosis and treatment, thus providing a good final result.

Immediately return to the doctor if you or your child have taken the medicine from the doctor, but do not experience improvement within 1 week. You also need to return to the doctor immediately if you or your child experience a recurrence of symptoms after several weeks of recovery. This can be a sign of complications, such as rheumatic fever.

Diagnosis of Scarlet Fever

To diagnose scarlet fever, initially the doctor will conduct a question and answer about the symptoms and complaints experienced by the patient. After that, the doctor will carry out a physical examination, such as looking at the condition of the tongue, throat and tonsils. The doctor will also check the lymph nodes and the appearance and texture of the rash.

If the results of the examination suggest that the patient has scarlet fever, the doctor will run a throat swab test, which is to take a fluid sample by wiping (swab) the back of the throat using a special tool for later analysis in the laboratory.

From the results of the analysis of the fluid sample, it can be seen whether or not S. pyogenes bacteria is present in the patient.

Scarlet Fever Treatment

Treatment for scarlet fever aims to relieve symptoms, prevent complications, and reduce the risk of transmission to other people. Some of the treatments that can be done to treat scarlet fever are:

Drugs

To treat scarlet fever, doctors can give oral antibiotics, such as penicillin or amoxicillin, for 10 days. For patients who are allergic to penicillin class antibiotics, doctors can prescribe erythromycin as an alternative.

Fever will generally subside within 24 hours after taking antibiotics. Even if the fever has subsided, it is important for the patient to continue taking antibiotics for up to 10 days so that the disease is completely cured and there are no complications.

Apart from antibiotics, doctors can also give other medicines, such as paracetamol, to relieve fever and sore throat. If the patient feels itching in the rash, the doctor can also give lotions containing calamine or antihistamine tablets.

Self-care at home

Apart from antibiotics, the following home remedies can also be done to reduce pain and make the patient more comfortable:

• Drink enough water to keep your throat moist and avoid dehydration.
• Gargle with a salt water solution to reduce swelling and sore throat.
• Consume throat lozenges, so that the inflamed throat feels more comfortable.
• Use a humidifier to get rid of dry air that can trigger a sore throat.
• Avoid irritants, such as cigarette smoke and cleaning products.

Scarlet Fever Complications

If not treated immediately, scarlet fever can cause several complications, such as:

• Ear infection
• Abscess of the throat or peritonsillar abscess
• Sinusitis
• Pneumonia

Although rare, scarlet fever can also cause more serious complications, such as:

• Rheumatic fever, which is a serious condition that attacks the nervous system, skin, joints and heart
• Inflammation of the glomeruli (glomerulonephritis)
• Liver damage
• Infection of the bones (osteomyelitis)
• Necrotizing fasciitis

Scarlet Fever Prevention

It should be noted that S. pyogenes bacteria can be transmitted from scarlet fever sufferers who do not feel symptoms. Therefore, it is important to always maintain personal hygiene. Some infection prevention measures that can be carried out and taught to children include:

• Make it a habit to wash your hands with soap until they are clean
• Do not use the same cutlery or take turns with other people, especially those who are sick
• Avoid sharing food, so the bacteria doesn't spread from or to other people
• Wash cutlery and toys with hot water and soap after use
• Maintain distance or wear a mask when interacting with scarlet fever sufferers

If you or your child is suffering from scarlet fever, things you can do to prevent spreading this infection to other people include:

• Cover your mouth and nose when you cough or sneeze, so the bacteria don't spread to other people
• Do not go to school or go to crowded places when you are sick

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