International Journal of Current

Medical and Pharmaceutical

Research
Available Online at http://www.journalcmpr.com
ISSN: 2395-6429 DOI: http://dx.doi.org/10.24327/23956429.ijcmpr20170185

CASE STUDY

SCARLET FEVER - A CASE STUDY

Binipaul V.J*
Department of Pediatric Nursing, Sreebalaji College of Nursing, Bharath University, Chennai
ARTICLE INFO ABSTRACT
Article History: Scarlet fever is a bacterial illness that develops in some people who have strep throat. Also known as
th
Received 4 May, 2017 scarlatina, scarlet fever features a bright red rash that covers most of the body. Scarlet fever is almost
Received in revised form 3rd always accompanied by a sore throat and a high fever.
June, 2017 Scarlet fever, also known as scarlatina, gets its name from the fact that the patient's skin
Accepted 27th July, 2017 especially on the cheeks is flushed. Sorethroat and raised rash over much of the body area
Published online 28th August, 2017 accompanied by fever and sluggishness (lethargy).

Key words:
Scarlet, sore throat

Copyright © 2017 Binipaul V.J. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.

INTRODUCTION
Case Study of Master X
Master x,11years old male, presented with a history of fever
,pain in throat, skinrashes, nausea, vomiting, body pain and
had itching 0n throat examination master x shows strep to
throat on blood culture he had evidence of infection.. Master x
was diagnosed to have scarlet fever.
Definition
Scarlet fever is an infection that is caused by a bacteria called
streptococcus. The disease is characterized by a sore throat,
fever, and a sandpaperlike rash on reddened skin.It is primarily
achildhood disease2. If scarlet fever is untreated, serious comp
lications such as Rheumaticfever (aheart disease) or kidney infl
ammation (glomerulonephritis) can develop.
Incidence
 Scarlet fever mainly affects children between 5 and
15 years of age.
 Although infections may occur year-round, the
incidence of pharyngeal disease is highest in school-
aged children during winter and spring and in a
setting of crowding and close contact3.
 Person-to-person spread by means of respiratory
droplets is the most common mode of transmission. It
can rarely be spread through contaminated food, as
seen in an outbreak in China.
Pathophysiology
As the name “scarlet fever” implies, an erythematous eruption
is associated with a febrile illness1. The circulating toxin,
produced by GABHS and often referred to as erythemogenic
or erythrogenictoxin, causes the pathognomonic rash as a
consequence of local production of inflammatory mediators
and alteration of the cutaneous cytokine milieu. This results in
a sparse inflammatory response and dilatation of blood vessels,
leading to the characteristic scarlet color of the rash.
Usually, the sites of GABHS replication in scarlet fever are the
tonsils and pharynx. Clinically indistinguishable, scarlet fever
may follow streptococcal infection of the skin and soft tissue,
surgical wounds (ie, surgical scarlet fever), or the uterus (ie,
puerperal scarlet fever).
Etiology
Book picture Patient picture
 Belong to Group A, Hemolytic streptococcus B Present
Gram(+) 0.6-1.0um in diameter
 Culture: grow in media contained blood
 Group: depend on the different somatic
polysaccharide Ag in cell wall, the bacteria are
divided into 19 group (A-U, nogroup (A-U, no I
and J). Group A is major.
 Serum type: Group A is divided into 80 types Not done
according to the protein M on surface.
 Resistance: weak resistance, sensitive to heat,
drying, common disinfectant. Live in sputum and
pus for several weeks. Not done
 Pathogenic substances
Not known
 International Journal Of Current Medical And Pharmaceutical Research, Vol. 3, Issue, 08, pp.2158-2159, August, 2017

Clinical Manifestation of Scarlet Fever Management for Master X

Book picture Patient picture Tab.penicillin
 A very sore and red throat (sometimes with Patient have sore and Tab.paracetamol
white or yellowish patches). red throat
Lotion lactocalamine
 A fever of 101 F (38.3 C) or higher, frequently
with chills. 12 to 48 hours later the rash will Tab domeperidone
appear. patient having fever
 Rash - red blotches appear on the skin; they 100F and having skin Nursing Intervention
then turn into a fine pink-red rash that looks rashes
Hyperthermia (100F) related to infection
like sunburn.
 The skin feels rough, like sandpaper, when  Complete bed rest was provided with proper position
touched
 The rash spreads to the ears, neck, elbows,
and provided good ventilation and adequate fluid.
inner thighs and groin, chest and some other Prescribed medication-tab paracetamol.
parts of the body
 If a glass is pressed on the skin the rash will
Fluid volume deficit related to vomiting
turn white (blanche). Patient develop
nausea  Provided plenty of cool fluids, fresh juice and soft
 Nausea
 Pastia's lines - broken blood vessels in the
Present food were provided. domeperidone is given to reduce
folds of the body, for example the armpits, vomiting. Prescribe drug is domeperidone.
groin, elbows, knees and neck.
 Stomach-ache Summary
 Swollen neck glands (lymph nodes) that are
tender to the touch Master x was cooperated with health personel. Although his
 Tongue - a white coating forms on the tongue. Vomiting present symptoms were well responding to treatment, it was recurring.
This eventually peels away leaving a Body pain He did not develop any complication during hospital stay.
strawberry tongue; the tongue is red and Having itching
swollen.
 Vomiting.
present CONCLUSION
present
 Difficulty swallowing present Prevention of disease is very important. When correct and
 General malaise present accurate treatment will not taken then complication may
 Headache
 Itching proceed. The nurse must include family members and other
 Loss of appetite support system when planning a patient care.
Reference
Diagnostic Evaluation 1. Terrikyle and susancarman “Essential of Pediatric
Book picture Patient picture nursing”, 2nd edition, Eleviser publication, pp 32-35.
Throat examination Strep throat 2. Wongs “Essential of Pediatric Nursing, US editors
Examination of the tongue White coating tongue
Laboratory test Evidence of infection
Marlin, Lippincott publication pp 89-90.
3. Balu H Athreya “Pediatric physical Diagnosis” second
Management edition, CBS publisher and distributer pp no- 78-79.
Antibiotic therapy
Rest
Analgesic
antipyretic
Tab.antihistamin
Antiemetic

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