visiting the doctor your subtitle goes here 猩 红 热 scarlet fever 北京大学第三医院...
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Visiting the DoctorYour subtitle goes here
猩 红 热Scarlet fever
北京大学第三医院 崔蕴璞
2. Epidemiology2. Epidemiology
Contents
1. Etiology
4. Differential Diagnosis
3. Clinical Manifestations3. Clinical Manifestations
Group A hemolytic streptococcal pyogenes.
Etiology
GAS
Extracellular Enzymes and Toxins:
Streptococcal pyogenic exotoxins(SPE) 红疹毒素Streptolysin O and S 溶血素Streptokinase(SK) 链激酶DNAases DNA 酶Hyaluronidase 透明质酸酶Proteinase 蛋白酶
2. Epidemiology2. Epidemiology
Contents
1. Etiology
4. Differential Diagnosis
3. Clinical Manifestations
Epidemiology
Epidemiology
传染源： 患者 健康带菌者
Epidemiology
传播途径：呼吸道飞沫食物、玩具间接经口皮肤伤口
Epidemiology
易感人群：
3~7 岁儿童
流行季节 :
Epidemiology
Winter Spring
2. Epidemiology2. Epidemiology
Contents
1. Etiology
4. Differential Diagnosis
3. Clinical Manifestations3. Clinical Manifestations
分 期
Incubation period 潜伏期
Prodromal period 前驱期
Rash period 出疹期
Convalescent period 恢复期
Incubation period
1~7days,mean 3days
No symptoms and signs
Common Type
Incubation period
Prodromal period
Rash period
Convalescent period
Prodromal period
Fever
Headache
Abdominal pain
Swollen glands in the neck
Sore throat
White strawberry tongue
Prodromal period
Purulent tonsillitis
Prodromal period
White Strawberry tongue Normal tongue
Common Type
Incubation period
Prodromal period
Rash period
Convalescent period
Rash period
Rash appears Whithin 24 ~48h after onset of fever
In 12~24h diffused to the whole body
Pastia’s lines
Pastia’s lines
Modality of the rash
a difffuse,fine papular
Sunburn with
goose pimples
Touch of the rash
fine sandpaper
Circumoral pallor
Red Strawberry tongue
By the 3rd or 4th
day the white coat peel off
Common Type
• Incubation period
• Prodromal period
• Rash period
• Convalescent period
Convalescent period
Rash Vanish in 2~4 days
Rash begin to fade at the end of the 1st week
Desquamation
at the end of the 1st week to the 2nd week desquamation occur
comes off as fine flakes like bran
糠屑样脱皮
Desquamation
usually the last to desquamate
not until the 2nd or 3rd week
Desquamation
Desquamation
Characteristic Manifestations
Fever
Typical rash
Strawberry tongue
Pastia’s lines
Circumoral pallor
Desquamation
2. Epidemiology2. Epidemiology
Contents
1. Etiology
4. Differential Diagnosis
3. Clinical Manifestations
Differential diagnosis
Rubella 风疹
Measles 麻疹
Differential diagnosis
Varicella 水痘
Differential diagnosis
Case
A seven year old boy presents with fever for
one day, the temperature rises to 39.5 ℃,
He felt unwell flesh and fell, and complaining
sore throat and headache,
Rash was detected in this morning
Case
PE: T 38.6℃, RR 32/min, HR 110 beats/min.
The mantal status is fine
The throat is red, and the tonsils are enlarged,
reddened, and covered with patches of exudate.
The skin is covered with tiny red spots
No abnormal sign is found in lung, heart and abdomen.
Summary
Scarler fever is an acute infectious disease
caused by group A hemolytic streptococcal pyogenes
Clinical features :Fever, Sore throat, Typical rash,
Pastia’s lines, Circumoral pallor, Desquamation
STSS: invasive GAS, shock and multiple organ
dysfunction
两天出疹猩红热，
咽痛皮疹伴发热，
红布喷点深红色，
疹退皮脱还原色。
多饮水，早退热，
七天抗菌别吝啬。
多休息，床上卧，
预防肾炎风湿热。
猩红热歌谣
