DEAR DR. DONOHUE: My 3½-year-old daughter recently had scarlet fever. I’ve been told it’s somewhat uncommon these days, and I’m not sure how she contracted it. Can you give some insight into the symptoms, incubation period and recovery time? – K.D.

ANSWER: Scarlet fever is a strep throat with one added attraction – a skin rash. Scarlet fever is a little less common than it once was. “Why” is an unsettled question.

Strep infections are common in children from ages 5 to 15. They reach their peak in the first years of school. Your daughter probably caught it from another child who carried the strep germ in his or her throat or nose and coughed or sneezed a mist of mucus and saliva that contained the germ into the air.

The incubation period is two to four days. The sore throat comes on abruptly, and sometimes a child complains of a stomachache when the sore throat appears. Tonsils enlarge and are covered with pus. Temperature rises to around 101 F (38.3 C). Lymph nodes in the neck and under the jaw swell and become tender.

The strep germ of scarlet fever behaves like other strep germs, except it makes a toxin that produces a skin rash. It’s a diffuse red rash that pops up on the chest, abdomen, neck, arms and legs. The face is covered with a flush except for a pale band of skin circling the lips. The skin has a sandpaper feel, which aids in recognizing scarlet fever in children with dark skin.

The fever goes away in three to five days, and almost all symptoms are gone in a week, except for the swollen glands. They take several weeks to return to normal. The skin peels like sunburned skin in a week.

The important aspect of scarlet fever and all strep throats is treatment with penicillin to prevent rheumatic fever. Rheumatic fever happens only to a few after an infection with strep throat, but it can bring permanent heart-valve damage.

DEAR DR. DONOHUE: I have lost count of the times I’ve asked you the following question, which is: In July of 2004, my granddaughter, who was almost 9 at the time, broke her upper leg. It was a bad fracture. A rod or pin was surgically put in the bone, and it is still there.

She is doing fine. She has only one restriction – don’t play soccer.

My feeling tells me it would be better to have this rod removed. Are there any disadvantages to leaving it in forever?

I hope to finally get an answer, one way or the other. – A.B.

ANSWER: Frequently, orthopedic hardware is left in place unless it causes pain, comes loose or the person must play contact sports.

As you know, artificial joints are metallic, and they are intended to stay there forever and ever.

I also have enough metal in my thighbone to set off airport security alarms through all of North America. I have no intention of ever having a scalpel pressed to my skin again, even in my dreams. I am leaving things just as they are. I’m getting along fine, as is your granddaughter.

I got to your question. I thought I’d better. That “one way or the other” had me worried.

DEAR DR. DONOHUE: I am cursed with sties . I get one, get over it and then another one is there. What’s the best way to treat them? I have been using a wet match, and I rub it on the sty. It’s something I learned from an uncle. It seems to get rid of them well. My uncle says it’s the sulfur in the matches. – L.H.

ANSWER: Sties are infections of the eyelid glands, usually with the Staph bacterium. When they come to a head and drain, that ends their life cycle. You can hasten the process by applying to them a washcloth soaked in warm water four times a day for 15 minutes each time.

Recurrent sties usually require antibiotic eye ointment or creams. They are prescription items. You might have a reservoir of Staph that needs to be eradicated.

Drop the match treatment. It doesn’t do anything.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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