Treatment for Scarlet Fever in Children
Scarlet fever commonly affects children aged 2 to 8, with acute and severe onset, strong contagiousness, and potential serious complications if not treated promptly. Parents should take it seriously; early diagnosis and treatment are essential once similar symptoms appear.
Diagnosis is relatively easy based on abrupt onset, typical rash, strawberry tongue, Pastia lines, perioral pallor ring, desquamation after rash fades, combined with systemic symptoms such as fever, sore throat, tonsillitis, and exposure history. However, differentiation from rubella and measles is necessary (already covered in previous sections). Additionally, medication history should be considered to rule out scarlet fever-like drug eruption.
Treatment includes general management and systemic medication:
(1) General care: Bed rest, adequate nutrition and hydration. Provide liquid or semi-liquid, easily digestible diet when sore throat occurs, maintain oral hygiene. Prompt fever reduction is required for high fever. Patients should be isolated for 3–4 weeks to prevent spreading to other children.
(2) Systemic therapy: Although antibiotics have increased in variety and potency, penicillin remains the first-line treatment for scarlet fever. Penicillin is highly effective against streptococcal infection, offering good therapeutic results and helping prevent complications such as acute glomerulonephritis and rheumatic fever. Penicillin G is generally used.
This condition belongs to the category of "warm diseases" in Traditional Chinese Medicine (TCM), known as "Lan Hou Dan Sha" or "Yi Sha." TCM attributes this disease to internal invasion by warm toxins, which ascend to affect the throat and spread throughout the body. Syndrome differentiation mainly falls into three types:
(1) Pathogenic factors affecting the lung and defensive layer: Sudden fever, sore throat, few rashes, thin greasy tongue coating, rapid pulse. Treatment principle: Clear heat and promote eruption. Formula: Modified Yin Qiao San.
(2) Heat invading qi and nutrient stage: High fever, irritability, severe sore throat, widespread rash, pale lips, strawberry tongue, rapid pulse. Treatment principle: Clear heat and cool blood. Formula: Modified Qing Wen Bai Du Yin.
(3) Post-rash yin deficiency: Rash has subsided but residual heat persists, fatigue, poor appetite, red tongue, fine pulse. Treatment principle: Nourish yin and clear heat. Formula: Modified Sha Shen Mai Dong Tang.
In addition to medication, ensure fresh indoor air, maintain appropriate temperature and humidity. Isolation treatment is recommended if possible. Encourage consumption of fresh, juicy fruits and vegetables during treatment. Avoid rich, greasy, spicy foods. Diet should be light. Patient’s clothing and bedding should be washed, sterilized, or sun-dried. <Scarlet Fever>