WITHб, 03 июн 2017 Автор: Елена Корнилова
Scarlet fever – an acute infection, manifested small-dotted rash
throughout the body, sore throat, fever, intoxication. Get sick more often
children. The main route of infection is airborne (by
talking, coughing, sneezing). Other ways (contact – household / through
dishes, toys, household items, linen / and water) are found
infrequently. From contact with asymptomatic carrier disease
develops extremely rarely, because they have streptococci
contained in small quantities and not so aggressive. By
statistics in 80 – 90% of cases of scarlet fever occur
easy with a favorable outcome in adults and children. Mortality
is hundredths of a percent.
Contents
The causative agent that causes scarlet fever
The causative agent – Streptococcus pyogenus (beta – hemolytic
Streptococcus group A). The bacterium produces erythrotoxin, and
the main clinical manifestations of the disease are due to its
effects on the body. Infection occurs not only from
a patient with scarlet fever, but also with some other pathologies,
since this microorganism causes a number of diseases:
• sore throat;
• give birth;
• streptococcal pyoderma;
• streptococcal intestinal infections, pyelonephritis, otitis,
pneumonia, etc.
Scarlet fever develops only in the absence of persistent man
immunity to erythrotoxin. If such immunity is maintained,
when infection can occur only angina. Also, infection can
occur through damage to the skin (cut, scratch, surgery), but
in this case, all occurrences of scarlet fever, except angina, will occur.
The development mechanism for scarlet fever symptoms and complications
The incubation period is from 24 hours to 10 days. AT
Over the next 3 weeks, the person is most contagious.
AT месте локализации стрептококка развивается воспаление,
caused by toxins excreted by the bacteria. Clinically with
scarlet fever inflammatory symptoms manifest themselves:
• hyperemia of the throat;
• increase in palatine tonsils;
• “crimson” language with enlarged papillae and a characteristic
thick white bloom at the root.
Erythrotoxin produced by streptococcus (“Dick’s toxin”),
penetrates the circulatory and lymphatic systems, destructive
acts on red blood cells, leading to intoxication. The smallest vessels
under the influence of eritrotoksina generalized expand: on the skin
and the mucous membranes appear punctate rash. By мере выработки
antibodies and toxin removal from the body the rash gradually disappears,
but there is exudate and edema of the skin, which eventually leads to
keratinization. Byявляется шелушение. Especially large amount of skin
peeling on the palms and soles.
If treatment is not started promptly, the toxin spreads.
blood to all organs and systems and causes severe complications in the form
nephritis, endocarditis, otitis, rheumatism, etc.
Clinical manifestations of scarlet fever, symptoms and their
diversity
If scarlet fever develops, its symptoms are high fever before
400 C with severe chills and intoxication (severe weakness,
lethargy or irritability, intense headaches,
dizziness, lack of appetite, aching all over, bad
or apathy and drowsiness, nausea, sometimes vomiting). The harder
the infection proceeds, the longer the high fever lasts.
With scarlet fever, the symptoms that characterize it are
rash and sore throat. AT верхней части тела появляется небольшое количество
rash Formed follicular – lacunar tonsillitis, accompanying
severe sore throat. ATсегда возникают изменения в лимфоузлах: они
increase, become dense and painful. AT тяжёлых
cases develops adenoflegmon of the neck.
Scarlet fever rash – a symptom of toxemia
The rash spreads from the top down, covering the person completely.
It has the appearance of small bright red dots. If the skin hold with
pressing a finger – a white stripe appears on the background of the rash, which
slowly returns its color. AT подмышечных впадинах, складках,
elbows its number is sharply increased, are formed brightly –
red stripes. If you hold your finger in these places – white strip
will not be. Distinctive feature – pallor of nasolabial triangle
(symptom Filatov). The harder течение скарлатины, тем больше
rash With a severe course of the disease, hemorrhagic
rash. In some areas of the skin, vesicles can form and
papules The rash disappears on day 7, leaving a peeling. On the soles and
palms skin can exfoliate in large layers.
You need to know that in some cases scarlet fever occurs without
rash
Scarlet fever – treatment must be complex
When scarlet fever treatment, taking into account the pathogen, is
antibacterial therapy. For 5 – 10 days, constituting
acute period, you must comply with bed rest. With a light
or the moderate course of scarlet fever treatment is carried out at home
conditions. A sick child or adult should be
separate room, its own linen and dishes.
For severe scarlet fever treatment is carried out permanently in
infectious disease department. Must be kept sparing diet: valid
semi-liquid, easily digestible food, age appropriate. WITH
first day, drink plenty of water to reduce
intoxication.
Antibiotics
When scarlet fever treatment should be comprehensive.
ATсем больным, независимо от степени тяжести болезни, назначается
antibiotic therapy. Antibacterial drugs quickly act on
pathogen, speeding up the healing process, and significantly reduce
risk of complications.
Penicillin antibiotics of the second – third are used.
generations. The course of treatment is 7 to 10 days. AT домашних условиях
Amoxicillin (Flemoxin-Solutab) and Amoxicillin with
clavulanic acid (Amoxiclav, Augmentin, Flemoklav – solyutab).
For severe forms, third-generation cephalosporins are used.
In case of intolerance to penicillin preparations, they are replaced by
макролиды (азитромицин /WITHумамед/), тетрациклины, цефалоспорины
first generation (Cefalexin, Cefazolin).
Antipyretic therapy
Жаропонижающие препараты при температуре выше 380 WITH. Детям до 12
years can be given children’s paracetamol or drugs based on it
(Panadol, Efferalgan). WITHтарше 12 лет возможно применение аспирина,
Нимесила и other НПATП. With severe intoxication in young children
convenient to use the rectal form of the drug in the form of candles. More often
3 times a day to give paracetamol is not recommended. Can
use rubbing, drink plenty of water, the child can not wrap:
даже при температуре воздуха выше +200 WITH можно оставлять
undressed.
Other drugs for scarlet fever
Byмимо этиологического лечения используются симптоматические
medicinal methods:
1. Antihistamines to reduce allergies
организма (WITHупрастин, Тавегил и other).
2. ATитаминотерапия — аскорбиновая кислота и витамины группв AT.
They should take at least 2 weeks, it is best to hold a course
lasting 1 month.
3. Irrigation of the pharynx with disinfectants to reduce
inflammation and prevent further development of the process.
Use any antiseptics for local use, taking into account
age indications and contraindications: Hexoral, Tantum – Verte,
WITHтоп – ангин, Ингалипт и other Их распыляют двумя дозами на обе
tonsils. If the age of the child allows, there is no vomiting, you can
several times a day to gargle with “sea water”: in a glass
boiled water dissolve 1 teaspoon of soda and salt, there too
add 3 drops of iodine. Good for rinsing a solution of 2
furatsilina tablets or 30 drops of calendula tincture per cup
water; decoctions of medicinal herbs (chamomile, calendula, sage).
4. Probiotics (live bacteria) and prebiotics (contributing to
increased reproduction of the normal intestinal microflora)
simultaneously with the antibacterial drug and after its course.
To determine the need for a particular drug should be a doctor.
Enterothermyna, Lineks, Atsipol – live bacteria, or
combinations: Bifido-bac, Bifido-bacterin, Biovestin-lacto and
other
Prevention
WITHпецифической профилактики при скарлатине не разработано.
Byэтому средствами защиты от инфицирования стрептококком является
personal hygiene
immune status. Byсле перенесенной инфекции развивается
lifelong immunity.
But scarlet fever is not a highly contagious disease,
therefore, even with prolonged communication with the carrier of bacteria or the sick
not every person with normal immunity can get sick. If
такое произошло, необходимо вызывать the doctor на дом и соблюдать все
prescription specialist.
