Терапевтический архив (Apr 2004)
Present-day clinical characteristics of scarlatina
Abstract
Aim. To study present-day clinical manifestations of scarlatina. Material and methods. The authors have reviewed 138 case histories of children with scarlatina treated outpatiently and 51 case histories of hospitalized scarlatina children as well as social and age characteristics of 1657 children and 108 adults hospitalized in the infectious hospital N 1 in 19622001. Official data on scarlatina morbidity in Moscow and Russia for 1991-2001 are presented. Antibiotic sensitivity of 414 cultures of group A streptococci (GAS) isolated in 1987-1995 and 1996- 2001 was investigated. Results. Overall and seasonal scarlatina morbidities in 7- 14-year-olds appeared to rise significantly. In the majority of cases scarlatina took a mild course but in the adults clinical picture of the disease was rather severe. GAS demonstrated high sensitivity (about 100%) to betalactamic antibiotics. The percentage of erythromycin-resistant streptococcal cultures increased more than 9-fold and reached 1.9% (1996-2001). There is a marked trend to a proportional increase of GAS cultures resistant to tetracycline and gentamycin. Conclusion. Recently, changes have occurred in scarlatina epidemiological and clinical features. Different sensitivity of GAS to antibiotics must be taken into consideration for prescription of etiotropic treatment and prevention of scarlatina at jobs.
