Acute streptococcal disease with interstitial rash, fever, general intoxication, angina, tachycardia. The causative agent is toxigenic streptococcus group A. The source of infection is a sick person, the most dangerous in the first days of illness. More often sick children up to 10 years. The incidence increases in the autumn-winter period.
Symptoms and course:The incubation period usually lasts 2-7 days. The disease begins acutely. The body temperature rises, the expressed malaise joins, a headache, a sore throat when swallowing, chills. A typical and permanent symptom is a sore throat: bright redness of the throat, enlarged lymph nodes, and also tonsils, on the surface of which plaque is often found. By the end of 1 and the beginning of 2 days, characteristic exanthemas appear (bright pink or red punctate rash, which thickens in places of natural skin folds). The face is bright red with a pale nasolabial triangle, but the edges of which can distinguish a punctate rash. Point hemorrhages are frequent on the bends of the extremities. The rash may have a cid of small bubbles filled with clear contents (miliary rash). Some patients have itchy skin. The rash lasts from 2 to 5 days and then turns pale, while the body temperature decreases. In the second week, lamellar skin lesion begins, most pronounced on the folds of the arms (finely and coarsely tubular). The tongue and the onset of the disease is coated, cleared by day 2 and takes on a characteristic appearance (bright red or "crimson" language).
From the side of the cardiovascular system, tachycardia is observed, moderate muffled heart sounds. There is increased fragility of blood vessels. In the blood - neutrophilic leukocytosis with a shift of the nuclear formula to the left, ESR increased. An increase in the number of eosinophils by the end of 1 - the beginning of 2 weeks of illness is typical. Lymph nodes are enlarged, painful. Possible increase in the liver, spleen.
On average, the disease lasts from 5 to 10 days. It can proceed in a typical and atypical form. Erased forms are characterized by mild symptoms, and toxic and hemorrhagic bleeding phenomena occur with prominent toxicosis (poisoning) syndrome: loss of consciousness, convulsions, renal and cardiovascular insufficiency.
Complications: lymphadenitis, otitis media, mastoiditis, nephritis, otogenic brain abscess, rheumatism, myocarditis.
Treatment:In the presence of appropriate conditions - at home. Hospitalization for epidemic and clinical indications. Bed rest for 5-6 days. Conduct antibiotic therapy with penicillin group drugs in daily average dosages, vitamin therapy (vitamins B, C, P), detoxification (hemodez, 20% glucose solution with vitamins). The course of treatment with antibiotics for 5-7 days.
Prevention:Isolation of the sick. Elimination of contact with convalescents with new admissions to the hospital. Discharge from the hospital no earlier than 10 days of illness. Children's institutions are allowed to attend after 23 days from the date of illness. In the apartment where the patient is located, regular disinfection should be carried out. Quarantine is imposed for 7 days for those who did not have scarlet fever after they were separated from the patient.