Scarlet Fever

Question 1

Scarlet fever is caused by a bacterial infection. What is the incidence of scarlet fever?

1 - 2.5 cases per 100,000
2 - 25 cases per 100,000
3 - 250 cases per 100,000
4 - 2500 cases per 100,000

Answer 1

2 - 25 cases per 100,000

Equally as likely in males and females

Question 2

Scarlet fever is caused by a bacterial infection. What age does the incidence of scarlett fever peak at?

1 - <12 months
2 - 1-5 years
3 - 10-21 years
4 - >21 years

Answer 2

2 - 1-5 years

Basically, children nursery

Question 3

What bacteria causes scarlet fever?

1 - staphylococcus aureus
2 - streptococcus pyogenes
3 - pneumococcal pneumonia
4 - jaemophilus influenzae

Answer 3

2 - streptococcus pyogenes

This is a Group A haemolytic Streptococcus

Question 4

The pathophysiology of scarlet fever involves streptococcus pyogenes, a Group A haemolytic Streptococcus that utilises its virulence factors. Which of the following are true regarding how the bacteria leads to scarlet fever?

1 - M protein and lipoteichoic acid for attachment
2 - hyaluronic acid capsule inhibits phagocytosis
3 - extracellular products, such as pyrogenic toxin, induce the rash of scarlet fever
4 - streptokinase, streptodornase (DNase B) and streptolysins
5 - all of the above

Answer 4

5 - all of the above

Question 5

What is the most likley route of transmission of scarlet fever?

1 - aerosol droplets
2 - contaminated food and water
3 - tick bites
4 - blood contact

Answer 5

1 - aerosol droplets

Question 6

What is the incubation period for scarlet fever?

1 - <24h
2 - 2-4 days
3 - <10 days
4 - <21 days

Answer 6

2 - 2-4 days

Question 7

Scarlet fever, caused by streptococcus pyogenes, a Group A haemolytic Streptococcus can infect a host of tissues, including all of the following. But which is most commonly affected?

1 - pharyngitis
2 - skin infections
3 - pneumonia
4 - nasopharynx

Answer 7

4 - nasopharynx

Often described as Strep throat

Question 8

Which of the following symptoms does NOT present in patients with Scarlet fever?

1 - fever: typically lasts 24 to 48 hours
2 - bleeding from mucosal surfaces
3 - malaise and headaches
4 - nausea/vomiting
5 - sore throat and strawberry’ tongue
6 - sand paper rash

Answer 8

2 - bleeding from mucosal surfaces

Can occur in Lassa fever, but not common in Scarlet fever

The rash typically begins on the torso, sparing palms and soles. C

Children often have a flushed appearance with circumoral pallor. The rash is often more obvious in the flexures. It is often described as having a rough ‘sandpaper’ texture. Desquamination occurs later in the course of the illness, particularly around the fingers and toes

Question 9

There are multiple methods for diagnosing scarlet fever, but which is most commonly used?

1 - Rapid antigen tests (RATs) and ‘strep tests’ use latex agglutination
2 - Enzyme-linked immunosorbent assays (ELISAs) are more expensive
3 - clinical diagnosis
4 - throat swab

Answer 9

3 - clinical diagnosis

Question 10

Which of the following vaccines provides immunisations against Scarlet fever?

1 - no vaccine available
2 - 6 in 1 vaccine
3 - meningococcal group B
4 - MMR

Answer 10

1 - no vaccine available

Question 11

There are a number of tests that can be used to try and diagnose patients with Scarlet fever, but should patient treatment be held until the results of any tests have come back?

Answer 11

• No

Treatment is typically clinical anyway, treat as soon as you think the diagnosis is most likely

Question 12

What is the 1st line treatment of choice for Scarlet fever?

1 - Azithromycin
2 - Ibuprofen and aspirin
3 - Vancomycin
4 - Penicillin

Answer 12

4 - Penicillin

If penicillin allergy then give Azithromycin

Plenty of fluid and paracetamol can be used if required

Question 13

If a patient develops Scarlet fever, they can typically be managed will in the community using penicillin, fluids and paracetamol. However, all of the following are indications for ENT referral, hospital admission and closer monitoring, EXCEPT for which one?

1 - Recurrent infection
2 - Child aged (5 y/o with fever and rash
3 - Difficulty swallowing may necessitate hospitalisation for intravenous fluids and antibiotics.
4 - Management of complications may require hospitalisation

Answer 13

2 - Child aged (5 y/o with fever and rash

Children can return to school within 24h of starting antibiotics, but if no antibiotics, remain home until symptoms have gone

Question 14

Although rare, which 2 of the following are serious complications of Scarlet fever?

1 - rheumatic fever
2 - cellulitis
3 - mastoiditis
4 - post-streptococcal glomerulonephritis

Answer 14

1 - rheumatic fever
4 - post-streptococcal glomerulonephritis

The other 2 can occur, but not as severe and more common