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Scarlatina la copil | Copilul.ro
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Scarlatina la copil

02 Martie 2012


 

Scarlatina este o boala infecto-contagioasa determinata de streptococul beta-hemolitic de tip A, fiind mai frecventa la copiii de gradinita si scolari, destul de rar sub 2 ani. Transmiterea se face pe cale aeriana, de la bolnavii cu scarlatina sau angine streptococice sau purtatorii de streptococ.

Dupa o perioada de incubatie scurta de 3-5 zile, debutul este brusc cu febra, cefalee frontala, disfagie (durere de gat) urmat de aparitia enantemului sau angina scarlatinoasa (fundul gatului rosu, amigdale marite si rosii,  cu depozite alburii, limba incarcata cu margini rosii si ganglionii din regiunea gatului mariti si durerosi).

Urmeaza exantemul scarlatinos sau eruptia cutanata – care consta in papule mici si rosii, rugoase (ca pielea de gaina)  ce apar la nivelul gatului, se extinde pe trunchi si membre.

La nivelul plicilor de flexiune (coate, genunchi) apar niste linii  subtiri rosii-violacee. Fata are un aspect „palmuit”: obrajii sunt rosii-aprinsi in timp ce buzele, barbia si zona din jurul nasului sunt palide.

Dupa disparitia eruptiei, apare o descuamare caracteristica: intai pe fata si trunchi cu scoame mici si apoi pe talpi si picioare unde scuamele sunt mai mari.

Complicatiile scarlatinei pot fi: complicatii imediate – care pot fi determinate fie de diseminarea streptococului (adenite, sinuzite, otite, otomastoidite, septicemii) fie de toxinele streptococice (miocardita toxica, hepatita toxica si meningita toxica).

Complicatiile tardive care pot apare sunt reumatismul articular acut si afectarea renala (glomerulonefrita). De aceea toti copii cu scarlatina se interneaza obligatoriu in spital timp de 7-10 zile, unde primesc tratament cu penicilina.

Dupa externare, pentru prevenirea complicatiilor se pot indica cure benzatin-penicilina (Moldamin); de asemenea, copilul va ramane izolat la domiciliu pana la a 14-21 – a zi de la debut si va fi urmarit  (clinic, VSH, ASLO, exudat faringian si examenul urinar) de catre medicul pediatru pana la 30 de zile de la debutul bolii.
Un titru ASLO crescut semnifica doar prezenta unei infectii streptococice in trecutul recent: acest titru creste dupa o infectie streptococica si este maxim la 3-6 saptamani de la debutul infectiei.

Daca se mentine crescut, este indicator al riscului de a dezvolta reumatism articular acut.

Alina Pop-Began
- Medic rezident -Anestezie si Terapie Intensiva-

Detalii specialist

Gradinita germana - educatie, arte, joc. Ateliere de dezvoltare pentru parinti si copii de la 2 ani. Descopera mai multe!

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