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Pediatría Atención Primaria
versão impressa ISSN 1139-7632
Resumo
FERNANDEZ ROMERO, V; RODRIGUEZ SANCHEZ, I e GOMEZ FERNANDEZ, G. Unusual clinical findings in an outbreak of scarlet fever. Rev Pediatr Aten Primaria [online]. 2016, vol.18, n.71, pp.231-241. ISSN 1139-7632.
Introduction:
scarlet fever is an infectious disease caused by Streptococcus pyogenes that manifests as a typical pharyngoamigdalitis and exanthema. Its diagnosis is usually easy, but atypical cases may go unnoticed.
Patients and methodology:
retrospective descriptive study of pediatric population assigned to a Primary Care center a health centre between 2013/2014. We define the epidemiology, clinical characteristics, microbiological tests, treat ment and appearance of relapses.
Results:
91 cases, resulting in an incidence of 3.2% of which 76 were confirmed microbiologically with a rapid test or culture. The average age was 4,15 years. The main reasons for consultation were "fever and sore throat" and "fever and rash". The most common alterations were pharyingeal hyper emia and petechiae on the palate and in a few patients we found tonsillar exudate. Almost 40% of patients had catarrhal symptoms. 71 patients showed a typical exanthema and 20 of them an atypical one. Most of them were treated with amoxicillin or penicillin for 10 days. 15 patients had recurrence.
Conclusions:
from the data obtained it is important to highlight the large amount of cases, the presence of catarrhal symptoms and the infrequency of tonsillar exudates. It was remarkable the variability of recurrences with findings such as extensive erythroderma, urticaria, macular rashes, atypically placed petechiae and facial and member edema. The rapid test on primary care units allows diagnosis on doubtful cases.
Palavras-chave : antigen detection testing; Exanthema; Streptococcus pyogenes; Children; Scarlet fever..