In the last month, pediatricians are seeing an increase in the number of diagnoses of strep throat and scarlet fever. Both diseases are caused by a bacterium called streptococcus pyogenes or group Streptococcus, and in scarlet fever the same bacterium produces a toxin that is characteristic of the skin rash. It is transmitted from person to person, through the drops of saliva that we emit when we speak and is most common in school children and adolescents, although it can appear at any age, which is rare under 3 years.
Streptococcal pharyngitis is usually accompanied by fever and sudden onset of sore throat, sometimes also headache, stomach or vomiting. When we examine the child, we can find a red throat, exudation in the tonsils (so-called plaque), painful and enlarged glands in the neck, inflammation of the grape or petechia (“red spots”) on the palate. If he has a cough, runny nose, stomach flu, or thrush, it is likely a virus.
Scarlet fever is a rash (skin rash) caused by toxins produced by the streptococcus itself. Usually with pharyngotonsillitis, but sometimes without sore throat or fever. Very noticeable spots appear on the skin, usually one or two days after the fever, with redness or little pustules, especially on the trunk or extremities, which sometimes itch. Pediatricians say that it is more to be touched than seen, since it is characteristic to pass the hand over the skin with sandpaper to remind the itchy lesions to the touch. It is usually more intense in areas where there are folds, such as the wings or groin. It can last up to 7 days and when the skin disappears, it becomes reddened many times.
Generally, with a clinical and physical examination, pediatricians can lead to the diagnosis of two pathologies. But there are also many viruses that can cause pharyngitis or skin rashes, so if there are any doubts, a rapid noise test can be performed (we call them “Streptotest”, in which a sample is collected from the throat and we get the result… in 5-10 minutes (based on the test note).In this way we will avoid the unnecessary use of antibiotics.
Treatment is based on taking antibiotics for 10 days. Penicillin is an antibiotic, as an alternative to amoxicillin. We will also treat the symptoms: if there is fever or pain, we will give paracetamol or ibuprofen; and if you have an itch, you could take an antihistamine.
Parents often ask us when they can go back to school and, in this case, scarlet fever and strep throat are exclusionary diseases of the school, not to infect classmates, not to go to school until they have completed 24 hours of antibiotic treatment and as long as they do not have a fever.
Complications are very rare today. The most common are rheumatic fever and streptococcal glomerulonephritis (kidney disease). One of the goals of treatment is to prevent these complications, in addition to suppurative complications (abscess – accumulation of peritonsillar or retropharyngeal pus). Another goal is to try to reduce the intensity and duration of the symptoms, but when the response to the antibiotic was very good (he soon stopped having a fever) he should maintain the antibiotic for the indicated 10 days. bacteria to be completely removed. and avoid complications.
At the end of last year, the health monitoring center in Britain covered the increase in serious infections caused by Streptococcus pyogenes. This bacterium is capable of causing many types of serious infections and affecting any part of our body (lung, blood, meninges, bone…). Among them was a toxic strike due to streptococcus, a serious clinical picture that usually occurs with bacteria in the blood and presents with fever and a lot of weakness with redness of the whole body. What this intent implies is that professionals consider the presence of symptoms to be a “set” complication for us. Therefore, we advise you that your pediatrician has probably told you on some occasion: alarm signs, which urgently need to go to the business (poor general condition, skin spots that do not disappear with pressure, fever that does not respond to antipyretics, shortness of breath, continuous vomiting, aggravating the throat and opening the mouth impotence).