What is scarlet fever and why is it dangerous. Is scarlet fever dangerous for pregnant women

Scarlet fever– acute infection. It is manifested by a small rash, intoxication and sore throat. It most often affects children, but adults can also become victims of this disease. All signs and symptoms of scarlet fever are caused by the action erythrotoxin (from the Greek "red toxin").

It is a poisonous substance that produces this species streptococcus. Having had scarlet fever once, a person develops immunity to beta-hemolytic streptococcus. Therefore, it is no longer possible to re-infect with scarlet fever.

What is the cause of scarlet fever?

Scarlet fever is an infectious disease caused by a microorganism. In this case, the causative agent of the disease is group A streptococcus. It is also called beta-hemolytic streptococcus. This bacterium is spherical in shape. It secretes Dick's toxin, which causes intoxication (poisoning of the body with toxins) and a small rash (exanthema). Inhabits the mucous membranes of humans. Most often they multiply in the nasopharynx, but they can live on the skin, in the intestines and in the vagina. For protection, bacteria can create a capsule around themselves, they are prone to the formation of clusters - colonies.

In some people, Streptococcus A may be part of the microflora. That is, it peacefully coexists with the human body without causing disease. But after stress, hypothermia, when immunity falls, streptococci begin to multiply actively. At the same time, they poison the body with their toxins.

source of infection with scarlet fever is a person. It could be:

1. Sick of scarlet fever, tonsillitis or streptococcal pharyngitis. Such a person is especially dangerous for others in the first days of illness.
2. A convalescent is a person who has recovered from an illness. He can still secrete streptococci for some time. Such carriage can last up to three weeks.
3. A healthy carrier is a person who has no signs of the disease, but group A streptococci live on the mucous membrane of his nasopharynx and are released into the environment. There are quite a lot of such people up to 15% of the total population.

Main route of transmission scarlet fever - airborne. When talking, coughing or sneezing, bacteria are excreted along with droplets of saliva and mucus. They enter the mucous membrane of the upper respiratory tract healthy person. Streptococci can find a new host in another way. For example, through toys, bed linen and towels, poorly washed dishes, food. There have been cases when infection occurred in parturient women through the birth canal.

Epidemiology of scarlet fever.

Today, this disease is considered a childhood infection. Most patients are under 12 years of age. But the disease can also occur in adults. But babies up to a year practically do not get sick. This is due to the fact that they inherited maternal immunity.

The patient is considered contagious from the first to the 22nd day of illness. There is an opinion that it can infect others a day before the first symptoms appear. This is due to the fact that during this period, streptococci are already in large numbers in the nasopharynx and stand out during conversation. But the immune cells of the body still keep the situation under control, so there are no signs of the disease.

The peaks of the disease are observed in September-October and in the winter, when children return from holidays to school or Kindergarten. In the summer, the number of cases decreases.

Due to the greater population density, the incidence is higher in cities. Urban children carry this disease in preschool and early school age and acquire immunity. And in rural areas, adults often get sick with scarlet fever if they have been in contact with a patient with scarlet fever.

Every 3-5 years there are epidemics of scarlet fever. Over the past decades, scarlet fever has become much more mild illness. If earlier mortality from it reached 12-20%, now it does not even reach a thousandth of a percent. This is due to the use of antibiotics for the treatment of scarlet fever with amelioration of staphylococcal toxicity. However, some researchers argue that every 40-50 years there are epidemics of "malignant" scarlet fever. When the number of complications and mortality rates rise to 40%.

What are the signs and symptoms of scarlet fever in children?

Scarlet fever in children causes severe poisoning with erythrogenic streptococcal toxin. Its action causes all the changes that occur in the body during illness.

The onset of the disease is always acute. The temperature rises sharply to 38-39 °. The child becomes lethargic, feels severe weakness, headache and nausea. This is often accompanied by repeated vomiting. By evening, a characteristic rash begins to appear. Its features will be discussed below.

Children complain of sore throat, especially when swallowing. The palate becomes red, the tonsils greatly increase and become covered with a whitish coating. This is due to the fact that streptococci A colonize the tonsils and multiply intensively there. Therefore, almost always with scarlet fever, streptococcal tonsillitis develops.

Lymph nodes that are at the level of the corners mandible, increase and hurt. With the flow of lymph, toxins and bacteria from the nasopharynx enter them, causing inflammation.

If the wound or cut served as the entrance gate for the infection, then angina does not develop. Other symptoms characteristic of scarlet fever persist.

What does a child with scarlet fever look like (photo)?

General state resembles a cold (fever, weakness)
The first hours of scarlet fever are similar to influenza or other acute illness.

Rash on the skin
But after about a day, a specific rash appears and others external symptoms. The rash of scarlet fever is called exanthema. It is caused by erythrogenic toxin, which is part of the exotoxin secreted by group A streptococcus.

Erythrotoxin causes acute inflammation upper layers of the skin. A rash is an allergic reaction of the body.

According to some characteristic outward signs scarlet fever can be distinguished from other infectious diseases. First small pimples appear on the neck and upper body. The skin becomes red and rough. Gradually, in 2-3 days, the elements of the rash spread throughout the body. The rash lasts from several hours to five days. Then peeling occurs in its place. This leaves the cells of the epidermis affected by streptococcus toxin.

Facial symptoms
The face of the baby becomes puffy, swollen. At the first glance at the child, a pale area around the lips attracts attention. It contrasts sharply with red cheeks and crimson lips. Eyes glow feverishly.

What does the tongue look like with scarlet fever?

What does a skin rash look like with scarlet fever?

Exposure to group A streptococcus toxin leads to the expansion of all small vessels. At the same time, lymph containing a toxin seeps through the walls of the capillaries. There is swelling and inflammation of the skin, a rash appears.

Symptom name	Description	what does it look like?
Rash on the skin	A pimple-like rash, roseola is very small and has a bright pink color, with a brighter center. Size 1-2 mm.
Pimples	They rise above the surface of the skin. It is almost not noticeable, but to the touch the skin seems rough, like sandpaper. This phenomenon is called "shagreen leather".
Dryness and itching of the skin	characteristic of scarlet fever. There is redness around the pimples. This is because the skin is inflamed. The elements are very small and arranged so densely that they practically merge.
Rash on body skin	more pronounced on the sides of the body, in the inguinal, axillary and gluteal folds, on the back and lower abdomen. This is due to the fact that the elements of the rash appear where sweating is stronger and the skin is thinner. Toxins from beta-hemolytic streptococcus are excreted through the pores of the skin.
Darkening in skin folds	In the folds of skin(neck, elbow and knee bends) dark stripes are found that do not disappear when pressed. This is due to the fact that the vessels become more fragile and small hemorrhages form.
White dermographism	white footprint It is formed if you press on the rash or hold it with a blunt object. This is important diagnostic sign, which is called "white dermographism".
Pale nasolabial triangle	Against the background of rashes on the skin of the entire face, a “clean” area of ​​the nasolabial triangle without a rash
Individual roseolas are not visible on the face	The rash is so fine that the cheeks appear uniformly flushed.
The rash lasts for 3-5 days	Sometimes only a few hours. Then it disappears without leaving dark pigment spots.
After 7-14 days, peeling of the skin begins	At first, in those places where the rash was more intense - in the folds of the body. Peeling is fine on the face, lamellar on the arms and legs. This is due to the death of skin cells and the separation of the upper layer - the epidermis.
The skin on the palms and feet comes off in layers	Due to the close connection between the epithelial cells in these areas. Peeling begins from the free edge of the nail, then moves to the fingertips and covers the entire palm. The disappearance of the rash and recovery is due to the fact that antibodies accumulate in the body. They bind toxins and relieve the manifestations of toxicosis.

What are the symptoms of scarlet fever in adults?

Scarlet fever is considered a childhood disease. This is due to the fact that by the age of 18-20, most people have already developed immunity to streptococci. But still, outbreaks of the disease occur among adults. Especially often in close closed groups: in student dormitories, among military personnel.

Currently, severe epidemics among adults are not common. In most cases, they proceed in the form of streptococcal pharyngitis without a rash.

Signs of scarlet fever in adults may not be as bright as in children. Often the rash on the body is imperceptible and insignificant, disappears in a few hours. This complicates the diagnosis.

Scarlet fever in adults begins acutely and has much in common with angina. Changes in the nasopharynx are caused by the fact that beta-hemolytic streptococcus multiplies most intensively in this area. It causes destruction of the mucous membrane. The intense red color of the palate and tongue is due to the fact that under the influence of toxins released by bacteria, small vessels expand. Also occur:

• severe sore throat that gets worse when swallowing
• a whitish-yellow coating appears on the tonsils, purulent foci and sores may occur
• submandibular lymph nodes enlarge and become inflamed

In adults, the symptoms of general intoxication are rapidly growing - poisoning with streptococcus toxin:

• high temperature, often up to 40°
• weakness and severe headache
• nausea and repeated vomiting in the first hours of illness

They are caused by Dick's toxin entering the bloodstream and spreading the infection throughout the body. This causes a small allergic rash. The skin becomes dry, rough, itching appears. Rashes have the same features as in children:

• the first rashes appear on the face
• the area below the nose to the chin without rash and sharply pale
• most of all, roseola is found in the folds of the body and above the pubis
• dermographism is observed - white footprint after pressing, which is noticeable for 15-20 seconds
• in severe cases, the rash may become bluish in color. This is due to small hemorrhages under the skin.

Streptococcus A can enter the body through cuts and burns. In this case, the rash is more pronounced near the wound where the bacteria have settled. Lymph nodes near the affected area become enlarged and painful. This is because they are trying to delay the spread of the infection. In them, as in filters, microorganisms and their decay products accumulate.

What is the incubation period for scarlet fever?

The incubation period is the time from the moment beta-hemolytic streptococcus enters the body until the first manifestations of the disease. This period of the disease is also called latent. A person is already infected, but the number of bacteria is not yet large and they do not have a tangible effect.

Incubation period for scarlet fever lasts from 1 to 12 days. In most cases, from 2 to 7 days. The duration depends on the state of immunity and the number of streptococci that have entered the body.

During this period, streptococci settle on the mucous membrane of the upper respiratory tract and multiply intensively there. The immune cells of the body try to destroy them, and at first they cope with their task. The body begins to produce special antibodies to fight the disease.

But then there comes a moment when there are too many streptococci and they intensively release toxins, undermining the strength of the body. Human immunity is not able to cope with them on its own and treatment is required.

How to prevent scarlet fever?

In order to protect yourself from scarlet fever, it is necessary to avoid contact with patients with scarlet fever and carriers of staphylococcus aureus. But, unfortunately, this is not always possible. After all, the carriers look absolutely healthy.

To protect yourself and your child, you need to know how the disease is transmitted.

• airborne- infection occurs when communicating, staying in the same room
• food (alimentary)- staphylococci get on products that a healthy person then consumes
• contact- transmission of bacteria from a sick person to a healthy person through household items, toys, clothes

Scarlet fever is not as contagious as others infectious diseases, for example, windmill. You can be in the same room with a sick person and not get infected. Susceptibility to disease depends on immunity.

Main preventive measures: identification and isolation of patients. In the team where the patient was, quarantine is imposed for a period of 7 days. If the child went to kindergarten, then those children who have not been in contact with the sick person are not accepted into the group. They are temporarily transferred to other groups.

During this period, conduct a daily examination of all children or adults who have been in contact. In children's groups, the temperature is measured daily, the throat and skin are examined. This is necessary in order to timely identify new cases. Pay special attention to signs respiratory infection and angina. Since this may be the first symptoms of scarlet fever.

Children who have been in contact with the patient are not allowed into kindergartens and the first two grades of school for 7 days after contact. This is necessary in order to make sure that the child is not infected.

A patient with scarlet fever is isolated and admitted to the team 22 days after the onset of the disease or 12 days after clinical recovery.

Everyone who communicated with the patient is prescribed Tomitsid. The drug must be rinsed or sprayed throat 4 times a day, after meals for 5 days. This helps prevent the development of the disease and get rid of streptococci that could get into the nasopharynx.

Most often, treatment is carried out at home. Patients are sent to the hospital with a severe course of the disease and in the case when it is necessary to prevent infection of small children or workers of decreed professions. These are the people who work with children, in medical institutions and in the field of nutrition. They are hospitalized for at least 10 days. For another 12 days after recovery, such people are not allowed in the team.

If a child in the family is ill, then the following rules must be observed:

• Avoid contact with other children
• put the patient in a separate room
• one member of the family must take care of the child
• do not wash the child's clothes with the linen of other family members
• allocate separate dishes, bed linen, towels, hygiene products
• carefully treat toys with a disinfectant solution, and then rinse with running water

In the room where the patient is located, disinfection is carried out. This is a wet cleaning with a 0.5% solution of chloramine. You also need to regularly boil the linen and dishes of the sick person. Such measures will help prevent the spread of streptococcus and infection of others.

Dispensary registration

In order to prevent the carriage of streptococcus, patients are under the supervision of a doctor for a month after discharge from the hospital. After 7 days and after a month, control blood and urine tests are performed. If necessary, make a cardiogram. If bacteria are not detected in the analyzes, then the person is removed from the dispensary.

What are the possible consequences of scarlet fever?

All complications with scarlet fever are due to the peculiarity of the bacterium that causes it. Beta-hemolytic streptococcus has a triple effect on the body:

• toxic- Poisons with bacterial poisons. Dika's toxin affects the heart, blood vessels, nervous system, adrenal cortex, protein and water-mineral metabolism is disturbed
• allergic- proteins that are formed as a result of the breakdown of bacteria cause an allergic reaction. This factor is considered the most dangerous
• septic- spreads throughout the body with blood flow and causes purulent foci of inflammation in various organs.

According to statistics, complications occur in 5% of patients. Of this number, almost 10% are heart lesions (endocarditis, myocarditis). In second place, 6% - pyelonephritis (inflammation of the kidneys). In third place is sinusitis (inflammation of the sinuses).

Complications after scarlet fever are divided into early and late.

Early complications of scarlet fever appear 3-4 days after the onset of the disease.

Consequences associated with the spread of the infectious process and the spread of beta-hemolytic streptococcus.

There may be:

• necrotic angina- destruction caused by streptococcus can lead to the death of mucosal areas on the tonsils
• paraamygdala abscess- accumulation of pus under the mucous membrane of the nasopharynx around the tonsils
• lymphadenitis- inflammation lymph nodes as a result of the accumulation of bacteria and their decay products in them
• otitis- inflammation of the middle ear
• pharyngitis- inflammation of the pharynx
• sinusitis- inflammation of the paranasal sinuses
• purulent foci(abscesses) in the liver and kidneys
• sepsis- blood poisoning

Toxic. Streptococcus toxin causes disturbances in the tissues of the heart "toxic heart". Its walls swell, soften, and the heart increases in size. The pulse slows down, the pressure drops. There is shortness of breath and chest pain. These phenomena are short-term and disappear after a sufficient amount of antibodies that bind the toxin accumulate in the body.

Allergic. An allergic reaction of the body to the bacterium and its toxins causes temporary damage to the kidneys. Its severity depends on the individual reaction of the body and on whether it has met with this bacterium before.
Allergy is a manifestation of vascular damage. They become brittle, internal bleeding occurs. Of these, cerebral hemorrhage is especially dangerous.

Late complications of scarlet fever

Late consequences are the most dangerous and are associated with sensitization of the body - allergies. As a result, cells of the immune system attack their own tissues and organs. The most serious allergic complications:

1. Heart valve disease- valves that ensure the flow of blood in the right direction, thicken. At the same time, the tissue becomes brittle and breaks. Blood circulation in the heart is disturbed, heart failure develops. It is manifested by shortness of breath and aching pain in the chest.
2. synovitis- serous inflammation of the joints - the result of allergization, occurs in the second week of the disease. The small joints of the fingers and feet are affected. It is manifested by swelling and soreness. It goes away on its own without treatment.
3. Rheumatism- damage to large joints, occurs at 3-5 weeks. In addition to pain in the limbs, complications from the heart can also appear. Rheumatism c is read as the most common and unpleasant complication of scarlet fever.
4. Glomerulonephritis- damage to the kidneys. After recovery, the temperature rises to 39 °. There are swelling and pain in the lower back. Urine becomes cloudy, its amount decreases. In most cases streptococcal glomerulonephritis treatable and goes away without a trace. But if measures are not taken in time, it can develop kidney failure.
5. Chorea- brain damage that occurs 2-3 weeks after recovery. The first manifestations: laughter and crying for no reason, restless sleep, absent-mindedness and forgetfulness. Later, uncontrolled movements in the limbs appear. They are fast and messy. Violated coordination, gait, speech. In some cases, the brain manages to compensate for impaired function, in others, the incoordination of movements remains for life.

Late complications after scarlet fever most often occur if the infectious disease was treated on its own without antibiotics or the diagnosis was incorrect.

Prevention of complications - correct and timely treatment scarlet fever. At the first sign of illness, you should consult a doctor. Taking antibiotics, antiallergic drugs and taking a large number liquids, this is a reliable protection against the occurrence of complications.

Is scarlet fever contagious, methods of infection?

Scarlet fever is a contagious disease. In order to get sick with it, you need to communicate with a patient with a sore throat, scarlet fever, or a carrier of a streptococcal infection. Also dangerous are people from the environment of the patient who have acute tonsillitis, nasopharyngitis, bronchitis. Most often, they also secrete hemolytic streptococcus.

There are four infection mechanisms:

1. Airborne- Infection occurs when communicating with a sick person or a carrier. The disease spreads rapidly in children's groups. When coughing, talking in the air, an aerosol is formed from small drops of saliva containing the pathogen. When it enters the mucous membrane of the upper respiratory tract of a healthy person, the bacteria primarily colonize the palatine tonsils (tonsils) and begin to produce a toxin. Over time, they spread to surrounding tissues and regional lymph nodes.
2. Domestic- through household items that the patient used. Toys, dishes, linen can become a source of infection if they get saliva or mucous secretions of a sick person. Although streptococcus somewhat loses its dangerous properties in environment, it can cause infection. This happens if a microorganism from things with dust enters the mouth or nose of a healthy person. The bacterium, being in favorable conditions, attaches to the nasopharyngeal mucosa, begins to actively multiply and produce toxins. Therefore, it is so important to carry out ongoing disinfection in the room where he is and not to allow the sharing of his things.
3. Food (alimentary)- if bacteria got on it during cooking, then such a dish can become a breeding ground for them and a breeding ground. Especially dangerous in this respect are dairy products that are not boiled and various jellies. When eating such food, a large number of microorganisms immediately enter the body. They linger on the nasopharyngeal mucosa and cause disease. Therefore, the examination of cooks and other kitchen workers for bacterial carriage is given so much attention.
4. Through broken skin- wounds, burns, damaged mucous membranes of the genital organs, the inner lining of the uterus after childbirth - can become the entrance gate for infection. Staphylococcus in this case does not multiply in the tonsils, but on the damaged tissue. This causes the rash to concentrate around the wound and the nearby lymph nodes to become inflamed.

Should antibiotics be used for scarlet fever?

Scarlet fever is one of the infections that are not caused by a virus, but by a bacterium. And if antibiotics do not affect the virus and cannot help a speedy recovery, then in this case the situation is different.

Antibiotic preparations effectively fight streptococcus. Already a day after the start of the reception, it is possible to stop the spread of infection throughout the body. Bacteria die and stop producing toxins. The patient feels much better. Therefore, antibiotics for scarlet fever are mandatory. The choice of drug depends on the severity of the disease:

• at mild form- prescribe penicillins and macrolides in tablets or in suspension for children: Erythromycin, Azimed, Azithromycin. Treatment period - 10 days
• with a moderate form - penicillins in the form of injections intramuscularly: Oxacillin for 10 days
• in severe form - cephalosporins of the I-II generation: Clindamycin, Vancomycin for 10-14 days. Administered intravenously

Thanks to antibiotic therapy, it was possible to turn scarlet fever from a deadly dangerous infection into a disease that is relatively mild. Antibiotics for scarlet fever make it possible to avoid the occurrence of life-threatening complications. In addition, they make a person safe for others from an epidemic point of view. It ceases to be contagious.

How to treat scarlet fever?

With scarlet fever, it is imperative to observe bed rest for 3-7 days. Its duration depends on the condition of the patient and the characteristics of the course of the disease.

In most cases, treatment takes place at home. The hospital is referred in such cases:

• in severe illness
• children from orphanages and boarding schools
• patients from families where there are persons who work in preschool institutions, hospitals, trade and public catering workers, as well as other representatives of decreed professions
• patients from families where there are children under 10 years old who did not suffer from scarlet fever
• if it is not possible to isolate the patient and organize care for him

Treatment for scarlet fever is based on antibiotics. But for a speedy recovery, an integrated approach is needed.

In parallel, other drugs are prescribed:

1. Antiallergic (antihistamine) agents - to eliminate the manifestations of allergies and complications that may arise due to the allergization of the body: Loratadin, Cetrin;
2. Antipyretic - to normalize the temperature and relieve headaches: Paracetamol, Ibuprofen;
3. Strengthening the wall of blood vessels - to eliminate the effect of toxin on blood capillaries: Askorutin, Galascorbin;
4. Means of local sanitation - preparations for cleansing the nasopharynx from bacteria: rinsing with Chlorophyllipt, Furacilin;
5. In a serious condition of the patient, he is administered intravenously saline solutions and glucose. This is necessary to maintain the water-salt balance and the speedy removal of toxins.

In order to quickly cure a sore throat with scarlet fever and clear the tonsils from streptococcus, physiotherapy is prescribed.

1. Irradiation of the tonsils with UV rays - they destroy the proteins of bacteria and cause their death.
2. Centimeter wave (CMW) therapy of tonsils - treatment of tonsils with microwaves.
3. Magnetic laser therapy - improves blood circulation and provides increased activity immune cells.
4. UHF therapy - has an anti-inflammatory effect, accelerates healing.
5. KUF-therapy - kills microorganisms, cleanses the tonsils from plaque.

Diet for scarlet fever

The nutrition of the patient should be aimed at maintaining the strength of the body, increasing the resistance to infection and reducing allergization. Food should be easy to digest. It must also be remembered that the sore throat is aggravated by swallowing. Therefore, the dishes should be semi-liquid and mashed. Doctors recommend therapeutic diet No. 13, which is prescribed for infectious diseases. It is necessary to eat often - 4-5 times a day, but portions should be small.

If there are no complications from the kidneys, it is necessary to drink 2-2.5 liters of fluid per day. This will help flush out the toxin from the body in the urine.

Phytotherapy and folk remedies will help alleviate the condition with scarlet fever. We offer some of the most effective recipes.

1. Gargle with decoctions of herbs. Chamomile, calendula, sage and eucalyptus are perfect for this purpose. Brew 2 tablespoons of one of the products with a glass of boiling water, let cool, strain.
2. Wash the horseradish root and grind on a grater. Pour a liter of hot boiled water and leave for three hours. Apply for rinsing 5-6 times a day.
3. Take half a glass of freshly squeezed beet juice, add a teaspoon of honey and apple cider vinegar and half a glass of warm water. Use as a rinse every two hours.
4. Pour half a glass of calendula flowers with hot water and simmer in a water bath for 30 minutes. Allow to cool and apply in the form of lotions on the site of rashes.
5. Ginger powder and licorice. Mix in a one to one ratio. Pour a tablespoon of the mixture with a glass of boiling water and leave to infuse for half an hour. Strain and drink in one go.
6. Grind a teaspoon of propolis and mix with a glass of milk. Warm up in a water bath for 15 minutes. Drink at night, after rinsing the throat.
7. Prepare a solution of citric acid. Dilute a spoonful of the product in a glass of warm water and gargle every 1.5-2 hours and after meals. Citric acid inhibits streptococcus and speeds up recovery. You can also suck on slices of lemon throughout the day.
8. Parsley root is well washed and chopped on a grater or finely chopped. One tablespoon pour a glass of boiling water and leave for 20 minutes. Strain and drink 2-3 tablespoons 4 times a day.
9. Acidic fruit and berry juices: lemon, cranberry, lingonberry - perfectly strengthen the body and kill bacteria. On the day you need to drink 2-3 glasses of juice or fruit drink. Drink warm in small sips after meals.

Should I be vaccinated against scarlet fever?

Today there is no specific vaccine against scarlet fever and other diseases caused by group A streptococcus. This is because there are a huge number of variants of these microorganisms. Pharmaceutical companies are trying to develop a vaccine against scarlet fever. To date, it is undergoing clinical trials, but it is not yet commercially available.

As a vaccination against scarlet fever is sometimes used:

• Intravenous multispecific immunoglobulin G. This remedy is made from the blood of donors and is administered to people whose bodies do not produce enough antibodies. Thus, passive immunity is ensured: proteins for protection against bacteria and toxins are not produced independently, but are introduced in finished form.
• Streptococcal toxoid. The drug is prepared from a weakened neutralized Dick's toxin. The tool causes the body to produce antibodies to staphylococci and their toxins. Increases the body's ability to fight infection and reduce intoxication during illness. Introduced subcutaneously into the area of ​​the scapula, if there was contact with the patient.
• Pyobacteriophage polyvalent / sextaphage. It is taken orally 3 times a day for 1-2 weeks or used as compresses. It helps boost immunity and dissolves streptococci and other bacteria.

However, these drugs do not give a 100% guarantee that infection will not occur. In addition, they have a fairly short period of action - from several weeks to one year. Contraindication to the use of these drugs may be hypersensitivity to their components. They can cause general allergic reactions, the most severe of which are anaphylactic shock. Therefore, it is necessary that the person remains under medical supervision for an hour after the administration of the drug.

The main role in the prevention of scarlet fever remains the overall strengthening of immunity. Complete nutrition, rich in protein products and vitamins, physical activity and hardening of the body. These measures will help protect the body from streptococcal infections and other diseases.

Most people have heard in general about such a disease as scarlet fever, but even with the current level of medicine, it is worth learning more about it. What is scarlet fever that it causes so dangerous symptoms. This acute infectious disease mainly affects the oropharynx, while there is severe intoxication of the body and a specific rash. The “culprit” of scarlet fever is group A streptococcus, which spreads by airborne droplets and contact routes. Typical symptoms are tonsillitis, regional lymphadenitis, fever, and a rash followed by flaky skin.

The disease was already known to Hippocrates, for the first time scarlet fever, what it became clear and described in detail in the middle of the 16th century.

Children are very susceptible to scarlet fever: the majority of cases are children from one to nine years old (susceptibility to infection among them is up to 40%). It is easier to get infected with scarlet fever in a team: children in kindergarten and school get sick 3-4 times more often than children who do not attend them. At the same time, this disease is not typical for infants and adults. Children under 3 months of age practically do not get sick with scarlet fever - for this they still have insufficiently mature immunity, in them infection with streptococcus causes mainly pneumonia.

There are several factors that multiply the risk of getting sick:

• low immunity;
• lack of vitamins;
• low hemoglobin (with iron deficiency anemia);
• high stress on the body (including mental).

Scarlet fever is caused by group A beta-hemolytic streptococcus. It can also cause sore throat, rheumatism, acute glomerulonephritis, streptoderma ... Which of them will develop in each case will depend on the interaction of streptococcus and the child's body.

The danger is not only a patient with scarlet fever, but also any carrier of streptococcal infection. In fact, there are quite a lot of carriers of streptococcus A: about 15–20% of people excrete it for months and even years, although outwardly they are completely healthy. The most dangerous are slightly ill children in contact with healthy ones, and adults with angina, since quite often angina is caused by the same microbe as scarlet fever.

Streptococcus is spread by aerosol. A child can excrete it while coughing or even talking, so the infection is mainly transmitted by airborne droplets. However, the causative agent of the disease settles on objects, so another way of transmission is important in the children's team - household (through shared toys, towels, etc.). Another possible path through broken skin. If streptococcus inoculates foods, the infection passes into the child's body with food.

After infection incubation period lasts from several hours to 12 days. The child is most contagious in the first 10 days of his illness, and 20 days after the appearance clinical symptoms the risk of infection disappears. Immunity to scarlet fever is usually lifelong, but will not protect against other diseases caused by streptococcal infection.

The disease of children with scarlet fever can be called seasonal: in the cold season, there are much more cases, since the immune system is weakened. Doctors also note the connection of scarlet fever with streptococcal tonsillitis and pneumonia.

Children get scarlet fever all over the world. The incidence of scarlet fever is characterized by periodicity, and epidemic outbreaks of scarlet fever have periodically occurred in the past. The short-term interval between rises is 2-4 years. At the same time, researchers also talk about larger time intervals (about 50 years), when the number of infected people is much more significant.

One of the well-known descriptions of scarlet fever is as follows: “At times there are periods of exceptionally benign or only malignant epidemics of scarlet fever. Mortality in malignant epidemics is 13-18%, but often rises to 25% and even reaches 30-40% ”(F. F. Erisman). However, in recent decades, doctors have noted that scarlet fever in children is not as severe as it used to be.

Metabolic products secreted by streptococci after entering the child's body act at the local and general level. local action is an inflammation of the mucous membranes or damaged skin at the site of entry of streptococcus. After being introduced into the body, the bacteria enter the lymph nodes and bloodstream with blood and lymph, affecting the cardiovascular, nervous, endocrine and other systems.

Streptococci have a toxic, septic and allergic effect on the child's body:

1. Specific intoxication is characteristic of all cases of scarlet fever at the onset of the disease, although its degree may vary significantly;
2. Septic manifestations - purulent and necrotic changes - are due to the influence of streptococcus itself. They can occur even with a relatively mild onset of the disease. Sometimes the septic effect becomes the main one from the first days - in the form of early purulent lymphadenitis, adenophlegmon, damage to the paranasal sinuses and other complications.
3. Allergic action is caused by sensitization of the body to beta-hemolytic streptococcus. It mainly manifests itself at a later date and represents the so-called allergic waves. Occasionally, an allergy manifests itself initially: in addition to a punctate rash, an urticaria rash forms, the face and eyes become swollen, all lymph nodes increase, and the number of eosinophils in the blood increases.

With a pronounced allergic state of the body, the vessels become more permeable, immunity decreases, barrier functions are violated. All this leads to the creation of conditions conducive to the penetration of microbes and an increase in septic action. Therefore, all three types of effects of streptococcus on the child's body are closely related.

If the course of scarlet fever is typical, it will not be difficult for the doctor to diagnose it. To fully confirm the diagnosis, the following diagnostic measures are carried out:

• during the examination of a sick child, the condition of the skin is checked, oral cavity, anterior cervical lymph nodes, revealing the external manifestations of the disease, measure the temperature, arterial pressure;
• carry out laboratory research blood to determine the level of neutrophils, eosinophils and ESR;
• take a swab from the throat to determine the presence of group A streptococci;
• take blood from a vein to find out if there are antibodies to the causative agent of scarlet fever.

At first sight, clinical picture scarlet fever is so expressive that it is impossible to make a mistake in the diagnosis. However, practicing pediatricians easily confuse it with rubella, measles, allergies, just a sore throat, and even prickly heat. This is due to the immunity of a particular child. If it is low, the disease can proceed erased - with virtually no rashes, high temperature and severe sore throat. In such cases, the throat swab becomes the main one: if group A streptococcus is determined, the diagnosis is considered confirmed.

No matter how easy scarlet fever is, the mainstay of treatment is antibiotic therapy (if the diagnosis is confirmed).

What is dangerous scarlet fever

Streptococcus DNA has a special molecular structure that allows you to very quickly cover the entire body of an infected child. Now there is already information about more than fifty of its strains, and all of them affect not only the mucous membrane of the oropharynx, but also the immune system as a whole. These bacteria can provoke acute purulent inflammation, therefore, with scarlet fever, complications in the upper respiratory tract are not uncommon, paranasal sinuses, lymphatic system.

Streptococcus is dangerous because it perfectly adapts to various conditions: it can remain viable for a long time when frozen, heated, and dried. Boiling, the use of disinfectants and ultraviolet will help get rid of this bacterium.

In the process of life, streptococcus produces special toxins that adversely affect the human body. One of the toxins is able to destroy various cells - blood, mucous membranes, epithelium. The second of them is a very strong allergen that can provoke autoimmune processes that are difficult to correct in the future. Streptococcus bacteria intensively secrete lytic enzymes that have a destructive effect on many tissues in the human body, such as muscle fibers or articular cartilage, which leads to complications in the activity of the musculoskeletal system.

Due to such a wide range of effects of the pathogen on the body, scarlet fever has been one of the main causes of infant mortality in the world. This continued until the beginning of the 20th century. After the invention of antibiotics, the death rate from scarlet fever has dropped significantly, and now most often the prognosis for a child with this disease is favorable.

Success in the fight against streptococcal infection provides the use of antibiotics. If they are used early in the course of the disease, the course of the disease will be mostly benign, although the possibility of toxic or septic scarlet fever, which is severe, cannot be ruled out.

Contrary to popular belief about lifelong immunity, there is a risk of contracting scarlet fever a second time. 2-3% of children are subject to this. Researchers believe that this is due to overly active treatment, when the body fights the disease so rapidly that the immune system simply has no time to form.

If a needed help is not fast enough, scarlet fever can lead to such complications:

• damage to the lymph nodes (lymphadenitis);
• inflammation of the ear (purulent otitis media);
• allergic kidney disease (glomerulonephritis);
• joint inflammation (arthritis, synovitis);
• heart damage (allergic myocarditis);
• inflammation of the lungs (pneumonia).

If a sick child started taking antibiotics at the very beginning and took their full course, the likelihood of complications is quite low. If treatment was not carried out or stopped too early, complications are almost inevitable. The most severe are rheumatic fever with damage to the heart and joints and glomerulonephritis: they begin two to three weeks after scarlet fever, and are mostly hidden.

To prevent this from happening, in addition to taking antibiotics, other measures must be observed:

• bed rest until the temperature returns to normal;
• drinking plenty of water to remove toxins from the child's body;
• special diet (mashed and warm food, rich in vitamins, but with limited protein).

Even if the child feels quite normal, it is worth limiting contact with other people for two to three weeks: this will also protect him from complications.

If suddenly complications arise, it is necessary to consult specialized doctors:

• a cardiologist if there are complaints about the work of the cardiovascular system (you may also have to do an ultrasound of the heart and an ECG);
• otolaryngologist, if otitis has appeared;
• urologist, if there are complaints about the state of the urinary system (sometimes ultrasound of the kidneys is necessary).

In order to detect such delayed complications on early stage, doctors recommend about a month after the child's recovery to examine him (at least, make an ECG and pass general analysis urine).

By the way, it has been noticed that in the youngest children there are mainly purulent complications, and in older children - allergic ones.

Unfortunately, there is no vaccination against scarlet fever yet, so all preventive measures come down to two directions. The first is strengthening the immune system and observing the rules of personal hygiene so as not to become infected by contact with a patient or a carrier of hemolytic streptococcus. The second is the observance of quarantine by a sick child, so as not to infect others.

A sick child should not visit the team and generally contact with strangers. He needs to allocate separate dishes, towels, and other personal hygiene items. Family members are encouraged to wash their hands frequently and diligently with soap and water. Clothes, bedding after the recovery of the child must be washed in hot water, the toothbrush must be replaced.

In general, a sick child will not become dangerous to others a day after the start of antibiotics, but due to the vulnerability of the body, it is still better to limit contact with others.

Development of scarlet fever

The peddler of scarlet fever is exclusively a person; it is impossible to catch this disease from animals. The danger may come from the patient in various ways. respiratory diseases, which are based on streptococcal infection (most often - tonsillitis or scarlet fever). Also able to infect a carrier of group A streptococcus, even if he does not have any clinical manifestations diseases. For the most part, children become infected in the garden or school, for a long time and closely communicating with each other.

The main route of invasion of scarlet fever bacteria into the body is the upper Airways, or rather, their mucous membranes. Where streptococcus has invaded, a local focus of infection appears, which has characteristic signs. In it, bacteria multiply, producing poisons that cause infectious intoxication.

Due to toxins that have penetrated into the general circulation, small vessels of various organs expand, and scarlatinal exanthema forms on the skin. Gradually, the child develops a specific antitoxic immunity, as a result of which the signs of intoxication and skin rashes gradually decrease.

In those rare cases when streptococcus enters directly into the bloodstream, it can affect a variety of organs - such as the membranes of the brain, lymph nodes, and the hearing aid. As a result, purulent-necrotic inflammation occurs, which, of course, is much more difficult to cure.

Scarlet fever begins in most cases abruptly. Sometimes the temperature rises to high levels in a couple of hours, the child begins to feel overwhelmed, weak, he may have a headache, and his heart rate will increase. Due to severe intoxication, vomiting is possible, as well as abdominal pain. Sometimes children do not become lethargic and indifferent, but, on the contrary, they become excited and fall into euphoria. However, it is worth remembering that at present scarlet fever is not always accompanied by a high fever.

At the very beginning of the disease, it becomes painful for the child to swallow. On examination, you can see brightly reddened tonsils, soft palate and palatine arches, uvula and posterior pharyngeal wall (this is a characteristic “flaming pharynx”). In contrast to the usual sore throat, with scarlet fever, the redness is much brighter, and a clear border of redness is visible in the place where the soft palate turns into a hard one.

Occasionally, a child develops follicular-lacunar tonsillitis: the tonsils become large, loose and very hyperemic, covered with plaque in the form of separate small (less often deep) foci. It is accompanied by regional lymphadenitis: the anterior cervical lymph nodes thicken and become painful.

The tongue is initially covered with a dense coating of a grayish-white color. After four or five days, the plaque disappears, and the tongue becomes bright red with a raspberry tint, with enlarged papillae. If the course of the disease is severe, the lips acquire the same color. The secretion of saliva decreases, due to which the mucous membrane of the mouth becomes overdried. begin to weaken, but there are malfunctions in the work of the cardiovascular system - tachycardia occurs, blood pressure rises.

A specific rash is formed in the first or second day of illness. Its peculiarity is its location on a generally reddened skin. The specificity of the rash plays an important role in the diagnosis. Scarlet rash spreads in a certain sequence: first on the face, neck and upper body, and then quickly cover the sides of the chest and abdomen, inner thighs, flexion surfaces of the limbs. In typical cases, the rash looks like small blisters with a cloudy liquid inside. Sometimes they merge, and the skin seems completely reddened.

It is characteristic that the rash, when pressed, disappears for some time in this place, and then appears again (white dermographism).

Scarlet exanthema has important feature: it becomes thicker on the folds of the skin, when the stripes of dark red rashes are located in the armpits, in the places of the elbow and inguinal folds. Typical places for a rash on the face are the cheeks, a little less often - the forehead and temples. The nasolabial triangle remains light and is not affected by rashes. In addition, the skin becomes dry. With an atypical course of the disease, rashes may appear later (on the third or fourth day of illness) or be completely absent.

On the fourth or fifth day after the onset of clinical symptoms of scarlet fever, the child begins to feel better. Gradually, the body temperature drops, brightens and the rash disappears. After a couple of days, the skin begins to peel off in small scales, on the palms and soles, these scales are larger. In children under two years of age, peeling may not be.

The number of rashes and the duration of their presence on the skin vary greatly. If scarlet fever is mild, the rash is small and does not last long - only a few hours. There is also a direct relationship between the intensity of rashes and the strength of further peeling of the skin. When the rash disappears, no pigmentation remains.

The classification is generally accepted and understandable. clinical forms scarlet fever according to A. A. Koltypin. He proposed to divide it according to the type, severity of the disease and the course of the infectious process.

First of all, typical and atypical forms of scarlet fever are distinguished.

Typical forms are classified according to two criteria.

According to the severity of the disease:

• light, transitional moderate(the temperature does not exceed 38 degrees, there is no pronounced intoxication, there is a rash in a typical localization);
• moderate, transitional to severe (temperature fluctuates in the range of 38-39 degrees, pronounced intoxication syndrome, profuse rash in typical localization);
• severe (toxic, septic, toxic-septic; patients need inpatient treatment in intensive care).

According to the course of the infectious process, scarlet fever is distinguished:

• without allergic waves and complications;
• with allergic waves;
• with allergic complications, purulent complications, septicopyemia;
• with an abortive course.

Among atypical forms scarlet fever secrete:

• erased;
• with increased symptoms (hypertoxic or hemorrhagic);
• extrabuccal (burn, wound, postoperative).

The extrabuccal form of the disease is formed when streptococcus enters the body not through the upper respiratory tract, but through damaged skin (for example, surgical incisions or abrasions). In this place, a purulent-necrotic focus occurs, and from it the rash spreads throughout the body of the child (that is, from the point of entry of the pathogen). In this case, lesions of the oropharynx are very rare.

You should not completely relax after the child's recovery: it is quite possible that you will have to go through more “allergic waves”. As a rule, they appear rather unexpectedly, when there are no signs of scarlet fever, and the condition is normal (usually this is the second or third week after the onset of the disease).

Characteristic signs of an allergic wave:

• an increase in temperature for a day or two, often insignificant;
• recurrence of rashes in the same areas (although the rash itself is not quite similar to scarlet fever: it is pale, it may disappear periodically);
• allergic manifestations (a runny nose and cough appear, tears begin to flow, the face becomes puffy, the level of eosinophils in the blood rises);
• enlargement of peripheral lymph nodes;
• increased heart rate (although a sick child may not feel it);
• lowering blood pressure.

There may be more than one allergic wave.

There are sometimes real relapses of scarlet fever. They are characterized by the return of the main symptoms - a specific rash, tonsillitis, temperature. For the most part, true relapses occur a month after the onset of the disease, sometimes they appear a little earlier. Such relapses occur due to re-infection of the body with streptococcus. Usually they are subject to those whose body could not develop (or developed, but not enough) antitoxic immunity. Often weakened children are predisposed to this - for example, those with chronic tonsillitis or rheumatism.

So, we continue talking about scarlet fever, as one of the serious infectious diseases of childhood, which can give serious complications without proper treatment. Although they are rare, it is worth knowing in advance how they are recognized, as they can pose a serious threat to the life or health of children and adults.

development of complications.
If from the moment of the onset of scarlet fever or after the onset of a sore throat, after a few days you began to notice suspicious symptoms in a child or in yourself, you should immediately consult a doctor. Health care needed in the presence of a sharp increase in temperature, which occurs, despite the ongoing therapy, there is a sharp increase in pain in the throat, there is a sharp and severe swelling in the right or left half of the throat. The sudden onset of severe headaches, pain in the forehead or face, around the eyes or under them, in the ear region, pain in the left or right ear is also dangerous. It is especially dangerous if a sick child or adult suddenly becomes very ill, there is a sharp weakness, loss of consciousness occurs, or the sick person develops chest pains, a severe cough, or complaints of severe difficulty breathing. Only a doctor, upon a detailed examination, can say whether this is the course of scarlet fever or its complications are already forming, requiring urgent intervention. If the assumptions are confirmed, then the necessary therapeutic measures will be taken to eliminate possible complications and .

What can be from complications?
A few weeks after the onset of the disease, various complications may occur. These include, for example, inflammation of the heart or joints. In rare situations, especially in children with scarlet fever, the immune system begins to produce special antibodies that can attack not only the infectious agent, but also the body's own cells and tissues. It is for these reasons that, about a couple of weeks after the onset of scarlet fever, children develop the so-called acute rheumatic fever condition. In this case, inflammation of the joints and tissues in the heart also occurs. To date, due to the widespread use of antibiotic therapy in the treatment of scarlet fever, complications from the heart and joints give less than 1% of children with scarlet fever or with existing streptococcal tonsillitis. Usually, inflammation in the joints associated with the development of scarlet fever is not dangerous and usually goes away without any serious consequences. But at the same time, inflammation of the heart tissue can be very dangerous, which can lead to severe disturbances in the functioning of the heart valves and even to the death of a sick child.

As a result of the research conducted by doctors, it was found that the development of acute rheumatic fever can be formed not only after the onset of a sore throat or endured scarlet fever, but also with external healthy people who are infected with beta-hemolytic streptococci, but do not have any clinical manifestations of infection. So, when conducting mass studies of children, it was found that out of the total number of those affected by acute rheumatic fever children, more than 60% before its onset had no signs of a sore throat or scarlet fever they had suffered, or there were minor symptoms of acute respiratory viral infections that were treated symptomatically. You should immediately contact the child with a doctor if, after a few days or weeks from the moment he was diagnosed with scarlet fever, you noted the following symptoms in the child:
- redness, pain and swelling in the joints, especially large ones such as elbow or knee joints
- severe weakness and shortness of breath, manifested at the slightest physical activity(when walking fast, when talking, when climbing stairs).
- if you experience pain in the heart or chest area
If these symptoms are associated with the presence of acute rheumatic fever, the doctor will need to prescribe to the child combined treatment with antibiotics and anti-inflammatory drugs.

It is also important to remember that scarlet fever itself, as well as the manifestations of rheumatic fever, can recur again, and with each new episode, more and more serious and severe violations work of the heart and lesions in the joints. In children who have already had rheumatic fevers once, the risk of their occurrence with each subsequent sore throat will be especially high. In connection with the above, if one of your children has rheumatic fever, you should discuss with your doctor the need for prophylactic antibiotic therapy for several years or even for life, which will not allow a strep infection to develop again and cause even more harm.

Kidney damage.
Another of the most serious complications of scarlet fever can be kidney damage in the form of acute streptococcal glomerulonephritis. By the same mechanisms as damage to the joints and heart, glomerulonephritis develops when kidney tissues are damaged by antibodies that the immune system a sick child develops against streptococcus. In some of the children with scarlet fever, antibodies, binding to microbes, begin active deposition in the area of ​​\u200b\u200bthe kidney tissue, which causes inflammation. The risk of developing glomerulonephritis with scarlet fever reaches 2%. Wherein inflammatory process in the tissues of the kidneys can be very pronounced, which can lead to a complete disruption in the work of these organs. In most sick children, kidney function gradually recovers over several weeks, but sometimes kidney damage can become irreversible.

You need to see a doctor immediately if, a few days or weeks after the onset of scarlet fever or tonsillitis, you notice symptoms in a sick child such as a sharp decrease or increase in the amount of urine excreted, a sudden change in the color of urine to red or dirty pink, pain in the lumbar region right or left, or abdominal pain. In the presence of glomerulonephritis, active treatment will also be necessary. According to experts, not all types of streptococcus can cause glomerulonephritis.

Defeat nervous system.
Approximately 25-30% of children who develop acute rheumatic fever may develop brain disorders. This is approximately 0.3% of all children who suffered from scarlet fever or streptococcal angina, they develop antibodies that the immune system addresses against streptococcus, but at the same time they can attack certain centers in the brain that are responsible for the formation of emotions, speech and coordination movements. In connection with this, some children with scarlet fever, a few weeks after the onset of the disease, may develop a special disease called Sydenham's chorea (PANDAS syndrome), appearing with the following symptoms:
- a change in the child's attitude to food of an inexplicable nature, or the child begins to greedily eat everything, or vice versa, begins to stubbornly refuse food
- unreasonable anxiety of the child, frequent and unreasonable cries of the child, strong aggression, unusual behavior
- sudden onset of bedwetting in a child
- the child develops strange movements of the tongue and mouth, arms or legs.
If you have similar or very similar symptoms, you should immediately consult a doctor. About half of the children who develop this type of chorea after suffering from scarlet fever recover completely within a few months. In other children, various psychological problems or disorders in the motor sphere may persist for a long time.

It can develop in almost anyone. This is due to the fact that people are very susceptible to the causative agent of scarlet fever. The disease is contagious and highly contagious.

The cause of the development of the disease is the ingestion of an infectious agent - group A streptococcus.

The disease is most common up to the age of ten.

Scarlet fever most often develops in people with chronic diseases, immunodeficiency states, during pregnancy.

Scarlet fever during pregnancy occurs because during pregnancy, women develop a physiological decrease in the level of the body's defenses.

The decrease in the body's defenses is protective in nature, it ensures the bearing of the fetus.

A pregnant woman can become infected through direct contact with a sick person. Infection occurs through communication, kissing, coughing, sneezing.

Infection is also possible when using common household items, dishes, through food.

Failure to follow the rules of personal hygiene increases the risk of developing the disease. It is also possible for streptococci to penetrate through burn surfaces, skin wounds.

But the carrier of a bacterial infection can also act as a source of hemolytic group A streptococcus. But for the development of the disease from the carrier, prolonged contact is needed.

Scarlet fever can cause outbreaks of disease development, especially in groups.

As already mentioned, people are very susceptible to this pathology. The pathogenic effect of a bacterium is caused by the toxin it produces.

The toxin spreads rapidly through the bloodstream through the blood vessels throughout the body.

Scarlet fever is characterized by seasonality, distribution in the cold season. The infectious patient remains for about three weeks, for this period isolation of patients is required.

Symptoms of the disease

After contact with a patient with scarlet fever before the development of signs of the disease, from one day to one and a half weeks.

If the pregnant woman did not have signs of the disease during this period, then most likely the disease will not develop.

Currently, cases of scarlet fever with a mild course are common.

But there may be cases of illness with an average and severe course. There is scarlet fever of typical and atypical forms.

For a typical form of the disease, the presence of all characteristic signs is characteristic, and with an atypical course, not all signs are present or there is an erased clinical picture.

After the contact of the pregnant woman with the patient during the incubation period, there may be slight headaches, general weakness, and a feeling of fatigue.

The onset of the pathological process is always acute, and bright clinical manifestations immediately appear.

In the first place are signs of intoxication of a pregnant woman:

• , with moderate and severe course to high numbers;
• severe general weakness;
• pain in muscles, bones;
• chills;
• nausea;
• vomit;
• stomach ache;
• cardiopalmus.

By the end of the first day, or after three days, the pregnant woman has changes in skin.

The first changes occur on the face, torso, later they spread to lower limbs. Rashes in the form small dots that merge in the folds of the skin. When the rashes merge, they look like a continuous area of ​​hyperemia (redness).

The rash spreads all over the body in two or three days.There are no rashes only on the skin of the nasolabial triangle.

When streptococcus enters through the oral cavity, damage to the mucous membranes of the oral cavity occurs. There are signs of the development of acute tonsillitis (tonsillitis):

• swollen tonsils;
• redness of the tonsils;
• purulent raids on the mucous membranes of the tonsils;
• patches with a grayish tint.

The raids can also cover the mucous membranes of the tongue, but after a few days the raids disappear. After the raids, bright inflamed papillae of the tongue appear, it becomes a characteristic crimson hue.

With the development of inflammation in the oral cavity, an increase in lymph nodes (submandibular and cervical) is noted.

Gradually, rashes on the skin turn pale and disappear, leaving no traces.

As the rash decreases with scarlet fever, changes in the oral cavity also disappear. Later, peeling of the skin appears, which gradually intensifies.

The skin from the palms and feet come off in layers. Changes in the skin are characteristic only for scarlet fever.

It is possible, given these changes, to retrospectively establish a diagnosis, or confirm. clinical course characteristic of the typical form.

An atypical course is observed when streptococcus enters through wound, burn surfaces.

With this form of scarlet fever, there are no lesions of the oral cavity, there are only rashes on the skin and intoxication.

It is also distinguished by the fact that the rashes spread from the place where they entered the body. This place is called the entrance gate.

The erased course is manifested in minor changes in the mucous membranes of the oral cavity and meager skin rashes which pass very quickly.

What is the danger for pregnant women

Like any infectious disease, scarlet fever is dangerous for a pregnant woman.

According to the most dangerous it is in the early stages of pregnancy. With the appearance of scarlet fever at this time, there is a risk of development: miscarriage (spontaneous abortion) and the formation of malformations.

On the later dates the following consequences of scarlet fever may occur:

• premature birth;
• lack of oxygen to the fetus (hypoxia);
• inflammatory diseases from other organs;
• inflammation of the lung tissue in a newborn.

Among inflammatory diseases other organs with scarlet fever are common:

• otitis;
• glomerulonephritis;
• septic shock;
• lymphadenitis;
• synovitis.

With a mild course of scarlet fever, the risk of complications is minimized, but this is possible only with timely access to a specialist and adherence to the recommended treatment.

Pregnant women especially should be very careful about their health.

What treatment is used during pregnancy

Treatment of a pregnant woman with signs of scarlet fever is carried out at home if she has a mild illness.

If the condition is more severe or there is a risk of complications, she is hospitalized in the infectious diseases department.

This is necessary for round-the-clock monitoring of the condition of the pregnant woman and the fetus.

A pregnant woman with scarlet fever must necessarily observe bed rest, this will avoid many negative consequences.

To reduce the intoxication syndrome, an abundant drinking regimen is necessary; in severe cases, intravenous drip infusions of various solutions are carried out.

Since scarlet fever is caused by the penetration of streptococcus, a course of antibiotic therapy is necessary.

But antibacterial agents for scarlet fever are selected taking into account the fact that the woman is pregnant. Antibacterial drugs prescribe safe for the fetus.

These drugs include the following drugs:

• Flemoxin Solutab;
• Amoxiclav;
• Augmentin;
• Azithromycin;
• Sumamed.

Any drug is prescribed by a specialist, doses are selected individually. Pregnant women with scarlet fever should not self-medicate.

It is possible to use antiseptic rinses [Miramistin], [Chlorhexidine] and folk remedies(chamomile, calendula, propolis).

Mandatory early treatment and competent treatment of pregnant women with scarlet fever contributes to a quick recovery.

Diseases during pregnancy do not please anyone. Especially when it comes to something more serious than a cold or an allergy to citrus fruits. In this material we will talk about a disease that is classified as children's - scarlet fever.

Scarlet fever is an acute infection caused by group A beta-hemolytic streptococcus. And although the “victims” of scarlet fever are most often children of preschool and school age, sometimes this disease does not spare pregnant women either. That is why the question of how dangerous scarlet fever is for a pregnant woman and her unborn baby is logical and relevant.

How to suspect scarlet fever?

The fact that a woman has scarlet fever is evidenced by some symptoms. First of all, it is a small-dotted rash (manifested on the first or second day of illness). At the same time, small pimples, if you press on them with your finger, will disappear, and then they will appear again. The most abundant punctate rash is localized on the face. At the same time, the nasolabial triangle remains clean from the rash and looks very pale. Another feature scarlet fever - the accumulation of a rash in places of natural folds, that is, on the folds of the skin. It manifests itself in the form of dark red stripes. Approximately on the fourth or fifth day, the rash becomes paler and soon disappears altogether, and peeling appears in this place.

Another symptom is a bright red (almost crimson) tongue. In addition to color, the graininess of the tongue is also noted. With all this, there is a significant increase in body temperature, and even fever. As a rule, the temperature rise reaches 38-40 degrees. There is also a general intoxication of the body. In almost all cases, scarlet fever is accompanied by a sore throat, since the throat (pharynx) is affected. In addition, an increase in the cervical lymph nodes is possible.

Very often scarlet fever during pregnancy is accompanied by severe vomiting.

After scarlet fever, various complications are possible, among which is purulent otitis media. Another fairly common complication is necrotic and purulent lymphadenitis. Infectious-allergic complications are not excluded. Perhaps the development of rheumatism. Leaves scarlet fever "imprint" and on cardiovascular system: blood pressure rises, tachycardia (rapid heartbeat) appears.

Scarlet fever during pregnancy does not threaten only the woman who has specific immunity to this infection. In other words, if a woman has previously had this disease.

How is scarlet fever transmitted?

Experts have found that scarlet fever is most common in regions with a temperate and cold climate. You can get infected with scarlet fever quite easily. This disease is transmitted by airborne droplets (sneezing, coughing, screaming, kissing, and so on) and through household items (toys, dishes, linen). There is also an alimentary route of infection, which involves infection through food. The source of infection with scarlet fever is a sick person (can be both a child and an adult). At the same time, there are practically no methods to prevent infection.

Ishchenko Irina Georgievna Obstetrician-gynecologist, ultrasound diagnostician, candidate of medical sciences, specialist in aesthetic gynecology

The most dangerous from the point of view of possible damage to the fetus are complications of measles, especially bacterial pneumonia, which can lead to the death of the fetus, and in especially severe cases, the death of the pregnant woman herself.

Scarlet fever during pregnancy: dangerous in the first 12 weeks!

Scarlet fever most common in children under 10 years of age. If a person in childhood did not suffer from scarlet fever, the possibility of developing the disease persists in adulthood.

What is scarlet fever?

Source and mechanism of infection

It is no secret that infectious diseases can seriously affect the development of a child, so it is recommended to treat them as early as possible.

Source of scarlet fever a person infected with scarlet fever, tonsillitis and other forms of infection can become. The cause of the spread of the disease is considered group A streptococci.

For others, the patient is a danger in the first 2-3 days of the disease. Contact with an infected person is considered relatively safe three weeks after infection.

Group A streptococcus is quite common among the population, its carriers are approximately 15-20% of the population.

Many carriers can excrete the pathogen for a long time, the likelihood of infection persists for several months and even years.

Can you get infected with scarlet fever? airborne, aerosol and contact and alimentary way. Streptococcus colonizes the skin, nasopharynx, provoking local inflammation (regional lymphadenitis, tonsillitis).

In the process of the development of the disease, streptococcus secretes an exotoxin that causes symptoms of poisoning and exanthema in the body. In the presence of favorable conditions for the growth and reproduction of microbes, resulting in lymphadenitis, otitis media. septicemia.

It is also worth noting the large role of allergic mechanisms involved in the development and occurrence of complications that manifest themselves at a late stage in the development of the disease.

Often complications are directly related to streptococcal superinfection and reinfection.

After the disease is cured, the body develops immunity. as a result, the likelihood of re-infection is minimized.

What is the danger?

Is scarlet fever dangerous for pregnant women? Often it is widely believed that scarlet fever is not dangerous for a woman and does not adversely affect the development of the fetus.

Severe disease is dangerous. treatment in this case requires antibiotic therapy, which is prohibited in the 1st trimester and not recommended in the later stages.

The most dangerous is scarlet fever in the early stages up to 12 weeks. because it can cause miscarriage.

Scarlet fever can also cause the following effects:

Diagnostics

Symptoms

During pregnancy, it is very important to monitor all the changes that occur in the body of a woman, Special attention should be given signs of manifestation various diseases .

Scarlet fever symptoms:

• malaise;
• temperature;
• the condition resembles purulent tonsillitis;
• sore throat;
• a rash characteristic only for this disease, the spots disappear after pressure, but appear after 4-5 hours.

signs

The first signal indicating the onset of scarlet fever is considered small rash, most often it occurs on the 2nd day after the end of the incubation period .

In women, rashes appear on the face, the nasolabial triangle turns pale and does not change color until recovery, there is usually no rash in this area.

Second in a simple way reddening of the tongue is considered to be recognized as scarlet fever; in the course of the disease, the tongue quickly acquires a color close to raspberry, its texture becomes more granular.

At the same time, the disease may be accompanied fever and temperature up to 40 degrees .

In the process of scarlet fever, toxic changes also occur in the body, which, taking into account toxicosis, is a great danger for pregnant women.

The disease is in most cases accompanied by symptoms of angina.. cutting pain in the throat, enlarged cervical lymph nodes, vomiting and toxicosis.

What complications can be with scarlet fever in a pregnant woman? After the end of the disease high risk of complications. most often it is otitis media, rheumatism. In more rare cases, purulent necrosis of the lymph nodes appears with the formation of a large amount of pus.

Due to allergic reactions rheumatic fever may develop pressure surges are observed, symptoms of tachycardia occur .

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Treatment

In the 1st trimester

Treatment of the disease involves diet and bed rest for a week .

General strengthening and immunostimulating therapy must be carried out, taking antibiotics during the first trimester is prohibited .

In 2nd and 3rd trimesters

In the second and third trimesters in severe cases, antibiotics may be prescribed penicillin series .

After recovery, a pregnant woman should take tests and do an ultrasound of the fetus.

Medications

For the treatment of scarlet fever are prescribed antiseptic preparations plant origin . in the 2nd and 3rd trimester, the doctor prescribes antibiotics of the penicillin series, most often this Erythromycin .

For gargling, solutions of furacilin and other plant substances are used.

Folk remedies

In the treatment of the disease are also actively used folk recipes, which allow you to alleviate the condition and individual symptoms.

• Saxifrage femur 1 tbsp cook in 0.5 l for 10-15 minutes. wrap, leave for 4 hours, drink the filtered mixture 0.3-0.5 tbsp. 3-4 p. in a day.
• 1 st. l. rhizomes medicinal valerian pour 1 tbsp. boiled chilled water, insist for 12 hours in a closed container, strain, use as a drink 1 tbsp. 3-4 p. a day before meals.

1. 1 tsp parsley roots brew 1 tbsp. boiled water, drink 1 tbsp. 3 p. in a day.
2. 1 st. lemon, lingonberry or cranberry juice drink warm, use the second glass for rinsing every 30 minutes. Mix the pomace from the berries with a glass of alcohol, use as a compress for the throat.
3. 1 tbsp sage pour 1 tbsp of boiled water, insist and strain, gargle with a solution.

Prevention

The best prevention of the disease is compliance with hygiene rules. it is recommended to clean the shower and bath with special products, keep the tiles on the walls and bath curtains clean.

Until the recovery of a patient with scarlet fever, it is not recommended to let him into the kitchen, feed him in a separate room.

Measles during pregnancy

Vybornova Irina Anatolyevna Obstetrician-gynecologist, endocrinologist, candidate of medical sciences

Bulatova Lyubov Nikolaevna Obstetrician-gynecologist, the highest category, endocrinologist, doctor of ultrasound diagnostics, specialist in the field of aesthetic gynecology

Like most children viral infections, measles is dangerous for pregnant women. When a pregnant woman becomes infected with measles in the early stages of pregnancy, in 20% of cases a spontaneous abortion occurs or fetal malformations occur.

The saddest thing about this situation is that the most frequent complications on the part of the fetus - oligophrenia (dementia) and lesions of the nervous system - are the worst diagnosed at this stage of pregnancy. Therefore, it is impossible to say for sure whether a particular pregnant woman is in those same 20%.

Most likely, the doctor will offer a woman who has had measles in the early stages of pregnancy, artificial termination of pregnancy. But, of course, in each case, the examination will be thorough and individual.

And it should be noted that measles, unlike rubella, is not an absolute indication for abortion.

It should be said that infection with measles in pregnant women in general is extremely rare. Even at a time when measles vaccination was not known, the number of pregnant women with measles was 0.4-0.6/10,000.

Chickenpox during pregnancy

Chickenpox (chickenpox) is an acute viral disease which is transmitted by airborne droplets. Chickenpox mainly affects children: they account for about 90% of cases of diseases. But sometimes this disease occurs in adults. Expectant mothers are not at risk for this disease: As a rule, chickenpox occurs in 1-2 women in 2000 pregnancies. Let's find out if chickenpox is dangerous for pregnant women, consider what complications can be after this disease, and determine the methods of its treatment.

In the case of a mother with chickenpox during pregnancy 4-5 days before the onset of childbirth, the probability of infection of a newborn baby is about 10-20%, while the mortality of sick children reaches 20-30%.

Congenital chickenpox in children is very difficult. As a rule, it is accompanied by defeat internal organs the baby, the development of bronchopneumonia (acute severe inflammation of the walls of the bronchioles). At the same time, if the mother was infected with the varicella-zoster virus earlier than 5 days before the birth, chickenpox does not appear in the baby or passes in a mild form.

First of all, the doctor will prescribe some examinations for the expectant mother. As a rule, a woman donates blood to determine the markers perinatal pathology(PAPP or HGH). In some cases, the doctor may refer a pregnant woman to a chorion biopsy, cordocentesis (fetal cord blood test), amniocentesis (amniotic fluid test).

If the expectant mother has chickenpox in late pregnancy, just a few days before the birth, doctors will try to delay the onset of labor for at least 2-3 days. Otherwise, immediately after the birth of the baby, immunoglobulin is administered and a course of antiviral therapy is prescribed. Naturally, the newborn is immediately hospitalized in the infectious diseases department. The same treatment tactics is carried out in case of manifestation of chickenpox in a mother who fell ill during the first 5 days after childbirth.

How to protect yourself from chickenpox during pregnancy

There are women who don't know or don't remember if they were sick chickenpox in childhood. Therefore, in order not to encounter chickenpox during pregnancy, it is best to donate blood to determine the presence of antibodies to the chickenpox virus in the body before planning to expand the family. The detection of such antibodies indicates the formation of immunity to this disease. In this case, you can be calm for yourself and the health of the unborn baby. The absence of antibodies to the chickenpox virus means that a woman is at risk of contracting the disease, and she needs to be more careful.

In order to protect yourself from infection with chickenpox during pregnancy, it is better for the expectant mother to avoid large crowds of people. It is especially not recommended to visit children's groups during this period.

Why is rubella dangerous during pregnancy?

Rubella - this disease passes without complications only in early childhood. For a pregnant woman, rubella is to some extent a death sentence. Indeed, at the very beginning of pregnancy, when the process of developing a baby from a zygote is just beginning, tissues and organs are formed from germ cells, an infectious disease such as rubella can lead to the need to terminate a pregnancy.

What is rubella? This is a viral disease of an epidemic nature, the incubation period in which is from fifteen to twenty-five days.

Infection occurs through close and prolonged contact with the carrier, however, in the presence of weak immunity, it is possible to become infected with a single contact with the patient. It is impossible to understand whether infection occurred or not during the asymptomatic stage.

Rubella disease is mild in children, manifesting itself as small reddish spots that spread as the disease progresses from top to bottom, elevated temperature body, aching in inflamed joints and swollen lymph nodes.

In adults, the course of the disease is much more severe. First, the body temperature rises significantly, rhinitis, sore throat and aching joints occur. These symptoms are similar to those of influenza, but the further course of the disease leaves no doubt in establishing the diagnosis. A rash appears on the body, enlargement of the lymph nodes and pain on palpation are observed. In especially severe cases, damage to the brain and destruction of small joints of the arms and legs is possible. Possible, but rare, death.

Rubella can be ill only once in a lifetime, so it is dangerous only for women who have not had it in childhood. Therefore, many parents, caring about the future of their children, purposely take them to a kindergarten or a nursery, while there is an epidemic of an infectious childhood disease, be it chickenpox, rubella or mumps.

The most severe nature of the disease in pregnant women, moreover, the main danger of the disease is for the fetus. The first trimester of pregnancy is the most critical, and if the fetus is infected, there is a high percentage of the probability of having a child with a congenital malformation. Birth defects lead to disability, impairment and often death before the age of one and a half years. Rubella is classified as an unconditional intrauterine pathogen. This means that the fetus from a pregnant woman can become infected.

After the 21st week of pregnancy, the risk of infection of the fetus ceases to be a reason for terminating the pregnancy. Even if the embryo becomes infected, the risk of it developing any congenital diseases becomes extremely low. Miscarriages in women with rubella occur before the 12th week of pregnancy, if a spontaneous miscarriage does not occur, artificial termination of pregnancy is most often prescribed.

If, after consulting a doctor, an infected woman in a position is not prescribed an abortion, she is included in a special risk group for pregnancy. Like ordinary patients, she is prescribed a course of treatment, which includes antibiotics approved for use by pregnant women, rinsing with antiseptics, and analgesics. Careful observation during pregnancy and childbirth is due to the fact that the disease is dangerous not only for the child, but also for the mother. During childbirth, bleeding, sepsis, and violation of labor can begin. If the child is still born, he will be infected and can infect others.

Is chickenpox dangerous for pregnant women?

Chickenpox during pregnancy is not a medical indication for its artificial termination. According to statistics, the risk for the fetus when infected with the chickenpox virus for up to 14 weeks is 0.4%, for a period of 14-20 weeks - about 2%, and after 20 and up to 39 weeks of pregnancy, the risk approaches zero.

At the same time, there is, although minimal, the likelihood of developing fetal pathologies with chickenpox during pregnancy. Sometimes when a woman becomes infected with this disease on early term miscarriage or intrauterine fetal death may occur. It is also possible for a child to develop cataracts (clouding of the lens of the eye), microphthalmia (the presence of pathologically small eyeballs), growth retardation, mental retardation, atrophy of the cerebral cortex, hypoplasia (underdevelopment) of the limbs, the appearance of skin scars.

It is more dangerous if a pregnant woman gets chickenpox in late pregnancy. The risk of infection of a newborn with chickenpox especially increases if a woman is sick with this disease 2 days before the onset of labor or for 5 days after them.

What to do if a pregnant woman has chickenpox

If a woman gets chickenpox during pregnancy, she does not need to panic in any case. modern medicine has enough methods and means to minimize the dangerous consequences of this disease.

In order to reduce the minimal risk to the fetus, in the case of chickenpox during pregnancy, a specific immunoglobulin is administered to a woman, which significantly reduces the effects of the varicella-zoster virus.