{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:57:58Z","timestamp":1760147878582,"version":"build-2065373602"},"reference-count":14,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T00:00:00Z","timestamp":1678492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Introduction: Scarlet fever is usually a mild childhood disease caused by type A streptococci. This disease is spread by droplets, mainly through direct contact with an infected person or the objects they have used. In pediatrics, these are significant risk factors for the transmission of infectious diseases. However, it is important to remember the possibility of serious complications in the course of scarlet fever. Aim: This paper provides a discussion of two pediatric cases in order to determine the possibilities of diagnosis, differentiation, and treatment of patients with severe, non-obvious courses of scarlet fever. Methods: The case reports of two patients hospitalized in a pediatric department due to Streptococcus pyogenes infection were examined. Results: The patients were admitted to the emergency room with symptoms not directly indicative of type A streptococcal infection, which required further diagnosis. Both patients complained of weakness at the time of presentation. They had an elevated temperature, were dehydrated during the course of gastroenteritis, and passed liquid stools without pathological admixtures. Further stages of diagnosis and treatment required hospitalization in the pediatric department. Therapeutic benefit from the implemented treatment was obtained, and the patients were discharged in good general condition with further recommendations. Conclusions: Medical history, which is often very detailed, can be the key to making the final diagnosis and can supplement the data collected on the basis of laboratory tests. Scarlet fever does not always occur with a mild course, and sometimes its course can be quite non-specific and may require a thorough diagnosis.<\/jats:p>","DOI":"10.3390\/children10030540","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T05:36:21Z","timestamp":1678685781000},"page":"540","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Toxic Streptococcal Infection in Children: Report on Two Cases with Uncharacteristic Course of Scarlet Fever"],"prefix":"10.3390","volume":"10","author":[{"given":"Krystyna","family":"Stencel-Gabriel","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0704-6282","authenticated-orcid":false,"given":"Dawid","family":"Konwant","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland"},{"name":"Doctoral School, Medical University of Silesia in Katowice, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina","family":"Szejnoga-Tu\u0142acz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S1473-3099(05)70267-X","article-title":"The global burden of group A streptococcal diseases","volume":"5","author":"Carapetis","year":"2005","journal-title":"Lancet Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e057772","DOI":"10.1136\/bmjopen-2021-057772","article-title":"Clinical management and impact of scarlet fever in the modern era: Findings from a cross-sectional study of cases in London, 2018\u20132019","volume":"11","author":"Herdman","year":"2021","journal-title":"BMJ Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4094","DOI":"10.1128\/JCM.00070-11","article-title":"Epidemiology of Invasive Streptococcus pyogenes Infections in France in 2007","volume":"49","author":"Lepoutre","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4103\/jgid.jgid_59_21","article-title":"Streptococcal pharyngitis in children: A tertiary pediatric hospital in Bucharest, Romania","volume":"13","author":"Miron","year":"2021","journal-title":"J. Glob. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"351","DOI":"10.18683\/germs.2021.1271","article-title":"\u201cRed throat\u201d or acute pharyngitis\u2014Challenges in real life clinical practice","volume":"11","author":"Miron","year":"2021","journal-title":"Germs"},{"key":"ref_6","first-page":"20499361221132101","article-title":"Seasonal variations and risk factors of Streptococcus pyogenes infection: A multicenter research network study","volume":"9","author":"Kennis","year":"2022","journal-title":"Ther. Adv. Infect. Dis."},{"key":"ref_7","unstructured":"(2022, December 05). Cases of Selected Infectious Diseases in Poland from 1 January to 15 August 2022 and in the Comparable Period of 2021, Available online: http:\/\/wwwold.pzh.gov.pl\/oldpage\/epimeld\/2022\/INF_22_08A.pdf."},{"key":"ref_8","unstructured":"(2022, December 05). Infectious Diseases and Poisonings in Poland in 2021, Available online: http:\/\/wwwold.pzh.gov.pl\/oldpage\/epimeld\/2021\/Ch_2021.pdf."},{"key":"ref_9","unstructured":"(2022, December 10). Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/groupastrep\/diseases-hcp\/Streptococcal-Toxic-Shock-Syndrome.html."},{"key":"ref_10","unstructured":"(2022, December 10). Canadian Paediatric Society. Available online: https:\/\/cps.ca\/en\/documents\/position\/invasive-group-a-streptococcal-disease."},{"key":"ref_11","first-page":"586","article-title":"Diagnosis and treatment of streptococcal toxic shock syndrome in the pediatric intensive care unit: Case report","volume":"31","author":"Fioretto","year":"2019","journal-title":"Rev. Bras. Ter. Intensiv."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"202","DOI":"10.3201\/eid1402.070888","article-title":"SevereStreptococcus pyogenesInfections, United Kingdom, 2003\u20132004","volume":"14","author":"Lamagni","year":"2008","journal-title":"Emerg. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"529","DOI":"10.3201\/eid2503.181518","article-title":"Increased Risk for Invasive Group AStreptococcusDisease for Household Contacts of Scarlet Fever Cases, England, 2011\u20132016","volume":"25","author":"Watts","year":"2019","journal-title":"Emerg. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1128\/JCM.02155-08","article-title":"Clinical and Microbiological Characteristics of Severe Streptococcus pyogenes Disease in Europe","volume":"47","author":"Darenberg","year":"2009","journal-title":"J. Clin. Microbiol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/3\/540\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:52:46Z","timestamp":1760122366000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/3\/540"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,11]]},"references-count":14,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["children10030540"],"URL":"https:\/\/doi.org\/10.3390\/children10030540","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2023,3,11]]}}}