A CASE of SCARLET FEVER Though the Source of the Infection Could Not Be Imagined
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My grand-daughter, agtd 7 years, during the last week of October 1931 was suddenly taken ill with fever and sore throat, the temperature in two hours' time reaching 101?F.; the tongue was coated with a thin white fur. A diaphoretic mixture, administered three-hourly, failed to lower the temperature. Twenty-four hours after the onset of the fever the skin from head to foot became and erythematous, with close-set hyperajmic ' papules, the patient looking as red as a boiled lobster'. The tonsils were enlarged arid Ihc breath was foul. The temperature during the eruptive stage of the rash went up still further to 105?F., and the patient became slightly delirious. It was now a typical case of scarlet fever A CASE OF SCARLET FEVER though the source of the infection could not be imagined. Ice-bags were applied to the head and sodium salicylate C. G. By DHANDHUKIA in a diaphoretic mixture was given four-hourly. Bhavnagar, Kathiawar On the third day of the illness the temperature was the was the fur on it had As scarlet fever is seldom seen amongst 104?F., tongue red, disappeared, the breath was foul, the stools were offensive and the and as the disease does not Indians, spread tonsils remained enlarged. The mixture containing in an epidemic form in India, I think the sodium salicylate had the effect of reducing the tempera- following case is worth recording : ture by, at the most, two degrees and this effect did 458 THE INDIAN MEDICAL GAZETTE [Aug., 1932 not last any longer than four hours after the adminis- tration of each dose; this necessitated its being given at regular intervals. This state continued till the sixth daj' when the rash began to fade and the temperature showed a gradual decline reaching only 103?F. in the evening. On the seventh day the temperature in the evening only reached 102?F. and application of cold to the head was no longer necessary. There was much irritation in the skin and the surface of the body was therefore frequently sponged with water. On the eighth day the temperature was 101 ?F., on the ninth 100?F., and on the tenth day of the illness it came down to normal and the patient was convalescent. Throughout this period the patient was fed with either plain orange juice, cooled with a little ice, or with orange juice with an equal quantity of milk, similarly cooled. Four or five days later the epidermis began to peel off and this process lasted for about a month during which time big flakes of the epidermis could be removed from the palms of the hands and soles of feet. Internal medica- tion during convalescence was not necessary, but the body was annointed daily with sterilized oil half an hour before her bath; this process rendered desquama- tion easy and shortened the period of desquamation considerably. During the eruptive stage the child lived in the same room as her younger brother and a still younger sister, and during the stage of desquamation she also played about with children in the street and yet none of her asso- ciates caught the infection, nor was any other case of scarlet fever seen in this town?Gadhada Swaminarayen, which has a population of about 5,500 inhabitants. Being the medical officer in charge of the State dispensary, I could not have failed to see them if any had occurred. The points of special interest are that this was a typical severe case of scarlet fever, the patient was an Indian living in the plains in India, and the case was a sporadic one, that is to say, the source of infection was not traced and, although the child was not isolated, no secondary cases were reported. .