Scarlet fever is an acute streptococcal infection caused by group A Streptococcus pyogenes that produce pyrogenic exotoxins A, B and C. The symptoms of the disease ensue from systemic toxin action. Toxins display superantigenic activity with massive production of proinflammatory cytokines. This results in fever, generalized rash, and skin desquamation. The disease profoundly impairs cardiovascular system especially microcirculation.
Scarlet fever transmission occurs by the air-droplet route. The illness affects predominantly children. It begins from a sharp rise of temperature, vomiting and throat pain. In 1-2 days characteristic skin rash appears and moves down from face to trunk and limbs. The patient demonstrates bright red cheeks and chin with a typical pale area around the mouth. The rash stays for several days and then gradually fades with skin desquamation (or peeling).
Almost all cases of scarlet fever are followed with specific oral lesions such as “strawberry” tongue with elevated deep-red lingual papillae an inflamed uvula.
Clinical diagnosis of the disease is supported by isolation of group A streptococci from the patient’s throat swab. Microbial culturing is performed on a number of special media for streptococci (blood or serum agar).
Scarlet fever is efficiently treated with antibiotics. Beta-lactams are the most commonly used antimicrobials here because of retained sensitivity of S. pyogenes to this group of drugs.