Last Updated: 2021-08-18
Filatow 1886, Dukes 1900.
4. infectious disease, Fourth disease, Dukes disease, Fourth disease, Rubeola scarlatiniformia, Parascarlatina, Dukes-Filatow disease.
Doubtfully independent exanthematic infectious disease that occurs in children. It is possibly a form of rubella or an abortive form of scarlet fever.
- Transmission: droplet infection.
- Incubation period: 9-20 days.
- Pathogen: Staph. aureus, mostly phage type 71.
- It is assumed that the exotoxin (epidermolysin) of Staph. aureus, mostly phage type 71 triggers the skin changes.
- Prodromal stage: as in measles and rubella.
- Exanthem stage: rubeoliform or small-spotted scarlatiniform exanthema.
- Clinical features
Predisposing sites are the intertrigines and neck region.
Mostly without complications.
- Bed rest
- Calf compress
- Application: > 12 y. (>40 kg): single dose (ED): 500-1000 mg, max. daily dose (TD): 4 g.
- 9-12 y. (30-40 kg): ED: 500 mg, max. TD: 2 g.
- 6-9 y. (22-30 kg): ED: 250-500 mg, max. TD: 750 mg.
- KI: liver damage, renal insufficiency, acute hepatitis, Meulengracht's disease, pregnancy, lactation.
- Lotio alba
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- Schlievert PM. Staphylococcal scarlet fever: role of pyrogenic exotoxins. Infect Immun 1981;31:732-6.
- Dunnet WN, Schallibaum EM. Scarlet-fever-like illness due to staphylococcal infection. Lancet 1960;2:1227-9.
- Barson WJ. Anterior uveitis associated with septic staphylococcal scarlet fever. Pediatr Infect Dis 1986;5:385-6.
- Okubo Y, Akaishi K, Fukui A, Hojo H. [Four Cases of "Staphylococcal Scarlet Fever"]. Shonika Kiyo 1963;9:215-2