Scarlet fever Classification and external resources
ICD-10	A38.
ICD-9	034
DiseasesDB	29032
MedlinePlus	000974
eMedicine	derm/383  emerg/402, emerg/518

Scarlet fever is a disease caused by an exotoxin released by Streptococcus pyogenes. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings A00-A79 - Bacterial infections and other intestinal infectious diseases and STDs (A00-A09 Intestinal Infectious diseases ( The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors An exotoxin is a soluble Protein excreted by a Microrganism, including bacteria, Fungi, Algae, and Protozoa. Streptococcus pyogenes is a spherical Gram-positive Bacteria that grows in long chains and is the cause of Group A streptococcal infections 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. Strawberry tongue is the appearance of tongue with inflamed red papillae, giving an appearance of Strawberry. A rash is a change of the Skin which affects its color appearance or Texture. Scarlet fever is not rheumatic fever, but may progress into that condition. Rheumatic fever is an Autoimmune inflammatory Disease which may develop two to three weeks after a Group A streptococcal infection (such as 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. Erysipelas ( Greek ερυσίπελας - red skin) is an acute Streptococcus Bacterial infection of the Dermis, resulting in inflammation Necrotizing fasciitis (NF or fasciitis necroticans, commonly known as "flesh-eating disease" or "flesh-eating bacteria" is a rare Infection Toxic shock syndrome ( TSS) is a rare but potentially fatal disease caused by a bacterial toxin. 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. An exanthem (from Greek "exanthema" a breaking out) is a widespread Rash usually occurring in Children. 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. Hemolysis (or haemolysis)—from the Greek Hemo-, Greek meaning blood - Lysis, meaning to break open—is the breaking Thermolabile refers to a substance which is subject to destruction/decomposition or change in response to heat Immunogenicity is the ability of a particular substance which is called the Antigen, to provoke an Immune response. Antistreptolysin O titre ( AS(LO titre or AS(LOT) - Titre of ( serum) antistreptolysin O Antibodies is a Blood test

History

This disease was known before the twentieth century as scarlatina (from the Italian scarlattina). The twentieth century of the Common Era began on 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. ^[1]

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 19th century of the Common Era began on January 1, 1801 and ended on December 31, 1900, according to the Gregorian calendar Scarlet fever is a disease caused by an Exotoxin released by Streptococcus pyogenes. Convalescence is the gradual recovery of Health and strength after Illness. 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

The flushed cheeks and paleness around the mouth of scarlet fever.

The scarlet fever rash.

Early symptoms indicating the onset of scarlet fever can include:^[2][3]

• Fever of 37 to 40 degrees C. Fever (also known as pyrexia, from the Greek pyretos meaning fire or a febrile response, from the Latin word Febris (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). See also Strep throat. Pharyngitis (ˌfarɪnˈdʒʌɪtɪs is in most cases a Painful inflammation of the Pharynx, and is A headache ( cephalalgia in medical terminology is a condition of pain in the Head; sometimes Neck or upper back pain may also be interpreted Vomiting (also called throwing up, emesis) is the forceful expulsion of the contents of one's Stomach through the Mouth and sometimes the The mouth, buccal cavity, or oral cavity is the first portion of the Alimentary canal that receives food and begins digestion by mechanically breaking up Pallor (also called pastiness or wanness) is a reduced amount of oxy Hemoglobin in Skin or Mucous membrane, a pale color which can Lymphadenopathy is a term meaning "disease of the Lymph nodes. A Lymph node ( lɪmf noʊd is an organ consisting of many types of cells and is a part of the Lymphatic system. The macule is the simplest dermatological Lesion. It is flat and can only be seen and not felt The palate (ˈpælɨt is the roof of the Mouth in humans and Vertebrate animals The uvula (ˈjuːvjələ is the conic projection from the posterior edge of the middle of the Soft palate, composed of connective tissue containing a number of Racemose
• 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. Skin folds are areas of Skin where it folds Many skin folds are distinct heritable anatomical features and may be used for identification of animal Species, while Desquamation is the shedding of the outer layers of the Skin. "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. "^[3] Peeling also occurs in axilla, groin, and tips of the fingers and toes. ^[2]

Diagnosis of scarlet fever is clinical. The blood tests shows marked leukocytosis with neutrophilia and conservated or increased eosinophils, high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and elevation of antistreptolysin O titer. Leukocytosis is a raised white blood cell count (the Leukocyte count above the normal range Neutrophilia (or neutrophil leukocytosis) is a condition where a person has a high number of Neutrophil granulocytes in their Blood. The erythrocyte sedimentation rate (ESR also called a sedimentation rate, sed rate, or Biernacki Reaction, is the rate at which Red blood cells C-reactive protein ( CRP) is a Plasma protein, an Acute phase protein produced by the Liver and by Adipocytes. Blood culture is rarely positive, but the streptococci can usually be demonstrated in throat culture. Blood culture is Microbiological culture of Blood. It is employed to detect Infections that are spreading through the bloodstream ( Bacteremia, The complications of scarlet fever include septic complications due to spread of streptococcus in blood and immune-mediated complications due to an aberrant immune response. Septic complications, today rare, include ear and sinus infection, streptococcal pneumonia, empyema thoracis, meningitis and full-blown sepsis, upon which the condition may be called malignant scarlet fever. See Pneumonia for a general overview of pneumonia and its other causes An empyema is a collection of Pus within a naturally existing anatomical cavity Sepsis is a serious medical condition characterized by a whole-body inflammatory state (called a Systemic inflammatory response syndrome or SIRS caused

Immune complications include acute glomerulonephritis, rheumatic fever and erythema nodosum. Glomerulonephritis, also known as glomerular nephritis, abbreviated GN, is a renal disease characterized by Inflammation of the glomeruli Erythema nodosum (EN ( red nodules) is an Inflammation of the fat cells under the skin ( Panniculitis) The secondary scarlatinous disease, or secondary malignant syndrome of scarlet fever, includes renewed fever, renewed angina, septic ear, nose, and throat complications and kidney infection or rheumatic fever and is seen around the eighteenth day of untreated scarlet fever. Otolaryngology is the branch of Medicine that specializes in the diagnosis and treatment of Ear, Nose, Throat, and head and neck disorders

Treatment

Other than the occurrence of the diarrhea, the treatment and course of scarlet fever are no different from those of any strep throat. Streptococcal pharyngitis or streptococcal sore throat ( Strep throat AmE) is a form of Group A streptococcal infection that affects the In case of penicillin allergy, clindamycin or erythromycin can be used with success. Clindamycin ( rINN; klɪndəˈmaɪsɨn is a lincosamide Antibiotic. Erythromycin is a Macrolide Antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of Penicillin, and is often used for people

Scarlet fever in popular culture

• Little Women by Louisa May Alcott (1868) - Beth contracts scarlet fever, seems to recover, but progresses to rheumatic fever and ultimately succumbs to congestive heart failure. Little Women or Meg Jo Beth and Amy is a novel by American author Louisa May Alcott (1832&ndash1888 Louisa May Alcott ( November 29, 1832 – March 6, 1888) was an American Novelist. Year 1868 ( MDCCCLXVIII) was a Leap year starting on Wednesday (link will display the full calendar of the Gregorian Calendar (or a Leap Rheumatic fever is an Autoimmune inflammatory Disease which may develop two to three weeks after a Group A streptococcal infection (such as Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply
• By the Shores of Silver Lake by Laura Ingalls Wilder - Laura's sisters Mary, Carrie, and Grace and their mother contract scarlet fever, the family recovers, but Mary is left blind as a result. By the Shores of Silver Lake, by Laura Ingalls Wilder, was published in 1939 and is the fifth out of nine books written in her Little House Laura Ingalls Wilder ( February 7, 1867 – February 10, 1957) was an American Author, who wrote the Little House series
• The Velveteen Rabbit by Margery Williams (1922) - The main protagonist, a small boy, contracts scarlet fever and his toys are all burned. The Velveteen Rabbit or How Toys Become Real is a children's novel written by Margery Williams and illustrated by William Nicholson. Margery Williams Bianco ( July 22, 1881 &mdash September 4, 1944) was an English - American author primarily of popular children's Year 1922 ( MCMXXII) was a Common year starting on Sunday of the Gregorian calendar. Indeed, the velveteen rabbit itself, the boy's favorite toy, was going to be burned by a nurse, but at the book's climax, the toy rabbit comes alive and joins the "real" rabbits outside in the garden.
• All-of-a-Kind Family by Sydney Taylor - Four of the five sisters come down with it, and the house goes under quarantine; no lasting harm to any of the patients.
• Frankenstein; or, The Modern Prometheus by Mary Wollstonecraft Shelley (1818) - Victor Frankenstein's adoptive sister Elizabeth contracts scarlet fever and recovers. Frankenstein or The Modern Prometheus, generally known as Frankenstein, is a Novel written by the British author Mary Shelley In Greek mythology, Prometheus (Προμηθεύς "forethought" is a Titan known for his wily intelligence who stole Fire from Zeus Mary Shelley ( Née Mary Wollstonecraft Godwin; 30 August Year 1818 ( MDCCCXVIII) was a Common year starting on Thursday (link will display the full calendar of the Gregorian Calendar (or a Common Victor Frankenstein is a Fictional character, the Protagonist of the 1818 novel Frankenstein, written by Mary Wollstonecraft Shelley But Victor's mother, who contracts the scarlet fever from Elizabeth, dies.
• The Witch of Blackbird Pond (1958) by Elizabeth George Spears - A young girl from Barbados is accused of giving scarlet fever to her cousins by using witchcraft. The Witch of Blackbird Pond is a children's Historical novel by American author Elizabeth George Speare, published in 1958 Year 1958 ( MCMLVIII) was a Common year starting on Wednesday (link will display full calendar of the Gregorian calendar. Barbados ( Portuguese word for bearded-ones, bɑrˈbeɪdoʊz -dɒs situated just east of the Caribbean Sea, is an independent Island nation Witchcraft, in various historical anthropological religious and mythological contexts is the use of certain kinds of Supernatural or magical powers
• Fever Dream by Ray Bradbury - the young protagonist is diagnosed with scarlet fever, though it appears to mutate into something much more sinister. Fever Dream is a Short story written by Ray Bradbury in 1948 It deals with the issues and anxieties suffered by teenagers that result from bodily change Ray Douglas Bradbury (born August 22 1920 is an American mainstream, Fantasy, horror, Science fiction and mystery
• Private Peaceful by Michael Morpurgo - Molly gets scarlet fever and survives. Private Peaceful is a novel written by Michael Morpurgo. It is about a soldier called Thomas or Tommo Peaceful who is looking back on his life from the trenches Michael Andrew Bridge Morpurgo OBE FKC (born 5 October 1943) is a British writer
• The first episode of the television show Ozzy & Drix featured a villain named Scarlet Fever, who died after getting sucked into the spleen and shredded. Ozzy & Drix The spleen is an organ found in all Vertebrate animals In humans the spleen is located in the abdomen of the body where it functions in the destruction of redundant Red
• In the 2001 film Osmosis Jones, the main antagonist is a strain of scarlet fever known as "Thrax," whose goal is to "get his own chapter in the medical book" after taking out his host, Frank, in 48 hours. Year 2001 ( MMI) was a Common year starting on Monday according to the Gregorian calendar. Osmosis Jones ( 2001) is a part animated, part Live action Film whose title character is Osmosis Jones an anthropomorphic An antagonist (from Greek ανταγωνιστής - antagonistes, "opponent competitor rival" is a character or In biology strain is a low-level Taxonomic rank used in three related ways A medical book or medical handbook is a Layman 's Reference book for health and medicine He had the ability to light fire to anything he touched, but was killed when he fell into a jar of rubbing alcohol. An infection is the detrimental Colonization of a host Organism by a foreign Species. Isopropyl alcohol (also isopropanol, iso, isopro, Rubbing alcohol, or the abbreviation IPA) is a common name for Thrax is voiced by Laurence Fishburne. Laurence John Fishburne III (born July 30, 1961) is an American award-winning Actor of screen and stage, as well as
• An American soldier in The Steel Helmet lost all of his hair as a child due to Scarlet Fever. The Steel Helmet ( 1951) is a war film directed by Samuel Fuller and produced by Lippert Studios during the Korean War.
• Anna Jones, mother of the young Henry 'Indiana' Jones died of Scarlet Fever during the year of 1912. Dr (also Col Henry Walton Jones Jr, better known as Indiana Jones or Indy after his pet dog is a fictional Adventurer, Soldier Year 1912 ( MCMXII) was a Leap year starting on Monday (link will display the full calendar of the Gregorian calendar (or a Leap year starting
• In his memoir Survival in Auschwitz, Primo Levi describes his stay at the Auschwitz concentration camp. If This Is a Man (Italian title Se questo è un uomo; United States title Survival in Auschwitz) is a work of witness by the Italian author Primo Michele Levi ( July 31, 1919 &ndash April 11, 1987) was a Jewish Italian Chemist, Holocaust survivor "Auschwitz" redirects here For the town see Oświęcim Auschwitz-Birkenau () was the largest of Nazi Germany In the later part of the book^[4], he mentions that he has developed Scarlet fever.
• Scarlet Fever is also the title of a 1983 hit single by Kenny Rogers. Kenneth Ray "Kenny" Rogers (born August 21, 1938, in Houston Texas) is an American Country music Singer-songwriter
• "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