Scarlet Fever - Rotlauf - Streptococcus

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Streptococcal infections in children (scarlet fever & Co.)

This group of diseases includes infections caused by a specific group of streptococcal bacteria (Lancefield-A) (the best known is scarlet fever). They usually lead to an acute infection of the upper respiratory tract, but can also cause other clinical pictures, such as tonsillitis, scarlet fever or red rash (sore throat, erysipelas). Pre-school and school children are particularly often affected, especially during the winter months…

navigation

• Continue reading
• more on the subject
• Advice, downloads & tools
• ">How are streptococci transmitted?

>

• What are the symptoms?
• Diagnosis & Therapy
• Whom can I ask?

>

How are streptococci transmitted?

Streptococci live in the upper airways of humans. Ten to 20 percent of the population are completely symptom-free germ carriers. It is transmitted as a droplet infection (e.g. by sneezing, coughing or speaking). There is no active or passive immunization against streptococci. In the event of a scarlet fever outbreak in a childcare center, school or family, prophylaxis with penicillin is useful and effective.

What are the symptoms?

Lancefield group A streptococci lead to various clinical pictures:

Local phenomena:

• Infants: especially sore throat (pharyngitis).
• Small children: colds, swelling of the lymph nodes, middle ear and sinus infections.
• From the age of three: after an incubation period of two to four days, typical symptoms of streptococcal pharyngitis or angina (painful inflammation of the tonsils and throat, sore throat and swallowing pain, usually fever, but no cough).
• Older children: "dirty lichen" (streptococcal impetigo), starting with vesicles that then become crusty with pus.

Scarlet fever:

• After an incubation period of two to four days, the disease begins as an inflammation of the tonsils and throat with fever, sore throat and difficulty swallowing. The mucous membrane of the throat and palate is dark red in color with later purulent coverings. The lymph nodes on the neck are swollen. The typical pale to bright red rash begins twelve to 48 hours later in the folds of the armpits and groin, spreads over the entire body and leaves a pale triangle of the mouth free. The skin feels like sandpaper or velvet. The tongue is initially whitish, from the third to fourth day of the disease it is very red with small nodules (raspberry tongue).

  The flaking of the skin begins in the shape of a bran around the seventh day, reaches its peak after two to three weeks and can last for up to eight weeks. The classic scarlet fever described here is rarely observed today because antibiotics are used early on.

• Extremely rare forms: Toxic scarlet fever with a fulminant course, high fever, delirium, cramps and skin bleeding can lead to death within a few days.

  The septic form shows signs of blood poisoning, including angina, otitis media and sinus infections.

Rotlauf (wound rose, erysipelas):

Acute skin infection from injuries, mostly on the face. The rapidly progressing reddening with swelling and the raised and irregular, sharply delimited edge of the reddening are typical. Fever and general complaints also occur

Diagnosis & Therapy

The diagnosis is confirmed by means of laboratory tests. The usual treatment is penicillin for ten days. Adequate hydration is also important. If necessary, fever-lowering measures are indicated. Bed rest is recommended when the child is ready.

Complications

Common complications are inflammation of the lymph nodes and sinuses, and tonsil abscesses. One to four weeks after an inadequately treated streptococcal infection, inflammation of the bone marrow, lungs, meninges, joints and blood poisoning can occur. Heart and kidney damage are particularly feared, and rheumatic fever and St. Vitus' dance (chorea minor) rarely occur. Two to three weeks after a strep infection, a thorough medical follow-up examination with urine monitoring and heart listening should be performed.

Whom can I ask?

As soon as the first signs of illness appear, you should take your child to a doctor specializing in general medicine or paediatrics.