Fourth disease: symptoms and diagnosis

Fourth disease: symptoms and diagnosis

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Betweenexanthematous diseasesalso the so-calledfourth disease, let's see what thesymptomsand what to do when it arrives in children or inadults.

Exanthematous diseases

The fourth disease, known asscarlet fever, it's aexanthematous diseasetypical of the pediatric age but, in more rare cases, it can also affectadults. In the medical literature it is also defined asClement Dukes disease, the most common name "fourth disease"Is linked to the fact that chronologically, in thechildhood, among the exanthematous diseases, thescarlet feverit is the fourth affection to manifest itself.

When do you take scarlet fever?
This disease comes in childhood, after measles, scarlet fever and rubella. It is followed by infectious erythema and the sixth disease.

In chronological order of arrival, the exanthematous diseases are:

  • Measles, also known asfirst disease
  • Scarlet fever orsecond disease
  • Rubella orthird disease
  • Scarlattinetta orfourth disease
  • Infectious rash, also known asfifth disease
  • Sixth diseaseo Critical rash
  • Seventh disease or chickenpox

Chickenpox in adults takes the connotation of St. Anthony's fire.

Fourth disease: symptoms

THE symptomsthey see, at first, the appearance of:

  • headache
  • loss of appetite
  • apathy
  • sore throat
  • discomfort in the light
  • drowsiness
  • mild feverish states
  • inflammation of the pharynx and laterocervical lymph nodes
  • rash (skin rashes)

The rash is mainly localized in the groin and buttocks, with small pink spots close together. How long does it last? The rash has a duration of 4-5 days and, upon its disappearance, a cracking or peeling of the skin may occur.


The exanthema can appear both in the form of spots and in a vesicular and sometimes petechial form. Most commonly it appears with pink spots similar to those caused by urticaria.

In many cases, thescarlet fever it is completely asymptomatic. Unlike other exanthematous diseases typical of the pediatric age, in this there is no striking increase in body temperature, therefore, in some "lucky" cases it could even go unnoticed. In the case of someexanthematous diseases, the risks are connected precisely to the appearance of thehigh feverthat could causeconvulsions.

Infourth diseasethese risks are eliminated, the only onescomplicationsrelevant may relate to renal function. When thescarlet feverhas now gone, to avoid any damage to the kidneys, a urinalysis is recommended.

The opinion of thepediatricianit is always recommended as, in some cases, prolonged antibiotic therapy may be necessary to relieve inflammation even after the disease.

Is it a bacterial or viral disease?

The scientific community believes that thescarlet fever is related to the virusCoxsackie, an enterovirus, this would explain the so frequent contagion in kindergartens. However, a small slice of the scientific community claims that it is a disease of bacterial origin.

Is it contagious?

In kindergartens, contagion is very likely due to the "cheeky" habits of children who pick their noses, touch each other ... :) The contagion can occur by direct contact with the sick child's mucus and saliva or even by indirect contact , that is, inhaling respiratory drops emitted into the air with a sneeze or cough.

How is the diagnosis made?

A simple throat swab, a urine test or a medical examination with an "physical examination" is enough for the diagnosis.

Fourth disease in adults

The adult is not immune to scarlet fever. If you never contracted this disease as a child, it could make it into adulthood without causing you serious symptoms. The symptoms seem to be comparable to the disease that occurs in pediatric age. In adults, it is more common to see rashes on the hands and feet although, in general, skin manifestations are more common in children than in adults. If you notice fever and spots on the skin and these have made you think of the fourth disease, do not rule out the hypothesis that it may be rubella, which is more common in adults.

Know that rashes (exanthema) can be a symptom ageneric, i.e. not characteristic for a given disease. L'rashin adults it could be the symptom of intolerance, of an allergy ... it is also the main symptom of syphilis (sexually transmitted disease) or of a condition caused by a lack of vitamin B2. Furthermore, the exanthema can present itself asundesirable effectof various drugs, such as levofloxacin, for example. For the diagnosis offourth disease in adultsit is best to consult a doctor.

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