The case dates back to March 2023. A 10-month-old child, with a fever of 38.5°C, was taken to the emergency room of the Virgen de la Arrixaca hospital, in Spain, in the Murcia region.
The parents warn that the older sister was suffering from scarlet fever. But the intern on duty sends the child home without a test, without antibiotics and without a higher opinion. Twenty-four hours later, the infant succumbed to the infection.
A missed diagnosis despite clear warnings
The High Court of Justice of Murcia swept aside the arguments of the defense which invoked the absence of a specific protocol.
For magistrates, the omission of a screening test – a simple and immediate procedure – constitutes a “blatant fault”.
The court emphasized that it was not necessary to be an expert to understand that a feverish baby living in contact with a proven case of scarlet fever presented a major risk.
“An infection with dazzling consequences”
Asked by True Medical on the dangerousness of this pathology in the youngest, Dr. Gérald Kierzek, emergency doctor, recalls that if scarlet fever mainly affects children aged 5 to 10 years, it must never be neglected in infants.
“Scarlet fever is a contagious bacterial infection caused by group A beta-hemolytic streptococcus, which can affect infants despite the relative protection of maternal antibodies.he explains.
According to the doctor, vigilance must be maximum because, in children under one year old, immune immaturity makes the infection “potentially more serious”. In this specific case, Dr. Kierzek is categorical:
“A rapid test (streptococcal RDT) and probabilistic treatment were indicated in the face of fever and family history, to prevent a rapid progression in a vulnerable infant.”
Understanding the symptoms and risks of scarlet fever
The disease manifests itself with high fever, severe sore throat and a characteristic rash. Dr Kierzek specifies that visual diagnosis is often possible:
“The “raspberry” tongue, first white then bright red, as well as a rough red rash are major clinical signs.”
Without rapid treatment with antibiotics, complications can be serious.
While recovery is usually rapid with treatment, the absence of antibiotics can lead to kidney damage. But not only that. Acute rheumatic fever is also to be feared or, in exceptional cases, “fatal sepsis or streptococcal toxic shock“.
Medical liability at the heart of the judgment
The judgment firmly rejects any attempt by the hospital to place responsibility on the parents. The Court held that non-professionals could not be expected to detect “the imperceptible worsening of a bacterial infection“. Nor even that they question the authority of a doctor.
As Dr. Kierzek points out, speed is key: “Early treatment avoids 99% of complications and limits contagiousness to just 48 hours.”. In this tragedy, it is precisely this intervention time that was lacking, transforming a common infection into a fatal outcome.
In summary, scarlet fever, although known and treatable, remains a disease to be taken seriously. In the event of fever in an infant exposed to a case of scarlet fever in siblings, isolation and urgent consultation with screening test must be systematic.
This tragedy reminds us that a seemingly benign infection can become fatal in infants. Experts insist: when faced with a fever and household contact with scarlet fever, every minute counts, and a rapid test combined with early treatment can save lives.