scarlatina n : an acute communicable disease (usually in children) characterized by fever and a red rash [syn: scarlet fever]

English

Noun

scarlatina

1. the disease scarlet fever

Derived terms

• scarlatina hemorrhagica

Scarlet fever is a disease caused by an exotoxin released by Streptococcus pyogenes. It is characterized by sore throat, fever, a 'strawberry tongue', and a fine sandpaper rash over the upper body that may spread to cover almost the entire body. Scarlet fever is not rheumatic fever, but may progress into that condition. The rate of development of rheumatic fever in individuals with untreated streptococcal infection is estimated to be 3%. The rate of development is far lower in individuals who have received antibiotic treatment.

Cause

Streptococcus pyogenes Bacterium (group A streptococcus) is responsible for scarlet fever. It can also cause simple angina, erysipelas, and serious toxin-mediated syndromes like necrotizing fasciitis and the so-called streptococcal toxic shock-like syndrome. The virulence of group A streptococcus seems to be increasing lately. The exanthem, or widespread rash, of scarlet fever is thought to be due to erythrogenic toxin production by specific streptococcal strains in a nonimmune patient. Besides erythrogenic toxins, the Group A streptococcus produces several other toxins and enzymes. Two of the most important are the streptolysins O and S. Streptolysin O, an hemolytic, thermolabile and immunogenic toxin, is the base of the anti-streptolysin O titer, an assay for scarlet fever and erysipelas.

History

This disease was known before the twentieth century as scarlatina (from the Italian scarlattina). Since the middle of the twentieth century the disease has, for reasons which are not understood, become much milder in its effects, and the usage of the name scarlatina has now replaced the term "scarlet fever" in some areas.

Many novels depicting life before the nineteenth century (see Scarlet fever in popular culture below) describe scarlet fever as an acute disease being followed by many months spent in convalescence. The convalescence was probably due to complications with rheumatic fever or even due to the treatments tried. Prior to an understanding of how streptococcus was spread and modern medicine, it was also not uncommon to destroy or burn the personal effects of a person afflicted with scarlet fever to prevent transmission to other people.

Signs and Symptoms

Early symptoms indicating the onset of scarlet fever can include:

• Fever of 37 to 40 degrees C.(101-104 degrees F.)
• Fatigue
• Sore throat
• Headache
• Nausea or Vomiting
• Abdominal pain
• Flushed face with paleness around the mouth (perioral pallor, circumoral pallor)
• Tachycardia (rapid pulse)
• Lymphadenopathy (enlarged lymph nodes)
• Punctate red macules on the hard and soft palate and uvula (Forchheimer spots).
• Bright red tongue with a "strawberry" appearance

• Characteristic rash, which:

• is fine, red, and rough-textured; it blanches upon pressure
• appears 12–48 hours after the fever
• generally starts on the chest, axilla (armpits), and behind the ears
• is worse in the skin folds
• Pastia lines (where the rash becomes confluent in the arm pits and groins) appear and persist after the rash is gone

• The rash begins to fade three to four days after onset and desquamation (peeling) begins. "This phase begins with flakes peeling from the face. Peeling from the palms and around the fingers occurs about a week later and can last up to a month.", he mentions that he has developed Scarlet fever.
• Scarlet Fever is also the title of a 1983 hit single by Kenny Rogers.
• "Casualty 1907" Episode 3 (BBC) Probationer Bennett contracts Scarlet Fever after caring for an infected patient. She ended up having to sweat it out along with Saline solution injections.

References