Difference Between Scarlet Fever and Kawasaki Disease

The key difference between Scarlet fever and Kawasaki disease is that Scarlet fever is an infectious disease while Kawasaki disease an inflammatory disease.

Scarlet fever occurs when an infectious agent produces erythrogenic toxins in a person who does not possess neutralizing antitoxin antibodies. On the other hand, Kawasaki disease is an uncommon form of medium vessel vasculitis that can give rise to coronary artery aneurysms if not treated properly.

CONTENTS

1. Overview and Key Difference
2. What is Scarlet Fever
3. What is Kawasaki Disease
4. Side by Side Comparison – Scarlet Fever vs Kawasaki Disease in Tabular Form
5. Summary

What is Scarlet Fever?

Scarlet fever occurs when an infectious agent produces erythrogenic toxins in a person who does not possess neutralizing antitoxin antibodies. Therefore, Group A streptococci are the most common pathogens that cause scarlet fever. Usually, this occurs as episodic infections but can occasionally there can be epidemics in residential places such as schools.

Clinical Features

This frequently affects children usually 2-3 days after a pharyngeal streptococcal infection. The clinical features of it include;

• Fever
• Chills and rigors
• Headache
• Vomiting
• Regional lymphadenopathy
• A rash that blanches on pressure appears on the second day of infection. It is generalized except in the face, palms, and After about 5 days, the rash disappears with subsequent desquamation of the skin.
• Flushed face
• The tongue has a characteristic strawberry tongue appearance initially with a white coating which later disappears leaving a raw looking, bright red “raspberry tongue”.
• Otitis media, peritonsillar, and retropharyngeal abscesses complicate the Scarlet fever.

Diagnosis

Diagnosis is principally based on clinical features and is supported by culturing of throat swabs.

Management

The prescribed antibiotic to counter the ongoing infection is Phenoxymethylpenicillin or parenteral benzylpenicillin.

What is Kawasaki Disease?

Kawasaki disease is an inflammatory disease. It is an uncommon form of medium vessel vasculitis that can give rise to coronary artery aneurysms if not treated properly. The cause of the disease is unknown and is believed to be because of autoimmune reactions. Usually, it affects the children of 4 months to 6 years of age and the peak incidence is during the first year of life.

Clinical Features

The clinical features of Kawasaki disease are;

• The children with Kawasaki disease are irritable and have an uncontrollable high-grade
• Conjunctivitis
• Cervical lymphadenopathy
• Mucous membrane changes- injection of the pharynx, cracked lips
• Erythema and swelling of palms and soles
• About few weeks after epidermis of the palms and soles starts to peel off.
• Sometimes, inflammation can occur at the BCG scar.

Investigations

The diagnosis of Kawasaki disease is possible within the first two weeks. Within the first two weeks, WBC and platelet count continue to rise along with CRP.

Management

• Infusion of immunoglobulins control the ongoing inflammatory processes within the first 10 days.
• Aspirin prevent thrombosis. Initially, a high inflammatory dose of aspirin is given until the inflammatory markers return to baseline. Then low antiplatelet dose is given for 6 weeks
• On confirmation of the presence of coronary artery aneurysms, we have to give warfarin.
• In case the symptoms persist, we have to give a second dose of intravenous immunoglobulins.

What is the Difference Between Scarlet Fever and Kawasaki Disease?

Scarlet fever is an infectious disease while Kawasaki disease is an inflammatory disease. This is the main difference between Scarlet fever and Kawasaki disease. Further, Scarlet fever occurs when an infectious agent produces erythrogenic toxins in a person who does not possess neutralizing antitoxin antibodies. On the other hand, Kawasaki disease is an uncommon form of medium vessel vasculitis that can give rise to coronary artery aneurysms if not treated properly. There are other differences between Scarlet fever and Kawasaki disease regarding their clinical features, diagnosis, and management.

Summary – Scarlet Fever vs Kawasaki Disease

Scarlet fever occurs when an infectious agent produces erythrogenic toxins in a person who does not possess neutralizing antitoxin antibodies and Kawasaki disease is an uncommon form of medium vessel vasculitis that can give rise to coronary artery aneurysms if not treated properly. Scarlet fever is caused by an infectious agent whereas Kawasaki disease is due to unexplained inflammatory reactions. This is the difference between Scarlet fever and Kawasaki disease.

Reference:

1.Parveen Kumar. Kumar and Clark’s Clinical Medicine. Edited by Michael L Clark, 8th ed.

Image Courtesy:

1.’Scarlet fever 1.1′ By Estreya at English Wikipedia (CC BY-SA 4.0) via Commons Wikimedia
2.’Kawasaki Disease’ By BruceBlaus – Own work (CC BY-SA 4.0) via Commons Wikimedia