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SCARLET FEVER. Definition Etiology Epidemiology Pathogenesis and pathology Clinical manifestation Laboratory findings Complications Diagnosis and Different Diagnosis Treatment Prevention. DEFINITION. Hemolytic streptococcus B group A Acute respiratory infectious disease

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scarlet fever

SCARLET FEVER

Definition

Etiology

Epidemiology

Pathogenesis and pathology

Clinical manifestation

Laboratory findings

Complications

Diagnosis and Different Diagnosis

Treatment

Prevention

definition
DEFINITION
  • Hemolytic streptococcus B group A
  • Acute respiratory infectious disease
  • Clinical features:Fever ,pharyngitis, genernal diffused fresh red eruption and obvious desquamation
  • Complication:heart,kidney and joints diseases
  • return
etiology
Etiology
  • Belong to Group A, Hemolytic streptococcus B Gram(+) 0.6-1.0um in diameter
  • Culture:grow in media contained blood
  • Group:depend on the different somatic polysaccharide Ag in cell wall,the bacteria are divided into 19 group(A-U,no I and J).Group A is major.
  • Serum type:Group A is divided into 80 types according to the protein M on surface.
  • Resistance:weak resistance,sensitive to heat,drying,common disinfectant .Live in sputum and pus for several weeks.
slide4
Pathogenic substances

1.LTA (lipoteichoic acid):adherence to epithelial cells.

2.Erythrogenic toxin:fever,rash and others

3.Strptokinase:resolve clot,protect blood from coagulation.

4.Hyaluronidase:extension in tissue,resolve hyaluronid.

5. M protein :toxic to WBC and PLT

return

epidemiology
Epidemiology
  • Source of infection

patients and carriers pharyngitis—major source

  • Route of transmission

air-borne: respiratory tract

wound,birth caral-surgical and puerperal type.

  • Susceptability

after infection of group A streptococcus, two Ab produce.antibacterial Ab-type specific no cross reaction,antitoxic Ab-five serotype persist no crass reaction

slide6
So,reinfection is possible especially pharyngitis

Epidemic features

1.season:every season,winter and spiring

2.age: every age,children

3.distribution of district

Change of disease

pathogenesis and pathology
Pathogenesis and pathology
  • Suppurative lesion:local-streptococcus

LTA adhere to epithelial cells and go into tissue

M protein resists phagocytosis(facilitate)

Hyaluronidase,streptokinase and hemolysins result in extension of inflammation and tissue necrosis

  • Toxic lesion:general and organs-erythrogenic toxin

erythrogenic toxin and other substances-

general toxic symptoms:fever, headache and bad appeptite,

slide8
skin:vascular congestion,eruption

signs:hepatomegaly and splenomegaly lymphonode fatty degeneration and congestion,myocardia and kidney injury.

  • Allergic lesion:complications myocarditis,myo calves and joints,base membrane of kidney are injured
  • return
clinical manifestation
Clinical manifestation
  • Incubation period:2-3days(1-7days)
  • Typical type:

1) Fever:39℃,1week

2)Pharyngitis:red exudation sore

3)Rash:24h after fever,diffuse erythema,1mm,pastauricular-neck-chest-limbs

4)companied signs:circumoral pallor,pastia’s lines,raspberry tongue-strawberry tongue.

5)desquqmqtion

6)No pigmentation

  • return
slide10
type
  • Septic type
  • Toxic type
  • Surgical or puerperal type
  • Mild type
  • Typical type
complications
Complications
  • Rheumatic fever
  • Glumerulonephritis
  • Arrhritis
laboratory findings
Laboratory findings
  • Blood Routine:WBC10-20X109/L,N>80%
  • Urine Rt: protein uria ,cast renal complication
  • Bacteriological examination: swab or secretion-culture
  • Dick test:
diagnosis and differential diagnosis
Diagnosis and Differential Diagnosis
  • Staphylococcus aureus infection

Primary septic site or transmission site or no pharyngitis or pathogen

  • Drug eruption

using drug or no pharygitis or relieve after stopping or pathogen

  • Streptococcus mi ti infection

sever or liver and kidney injury-shock or pathogen

treatments
Treatments
  • General therapy

Isolation 7 days, temperature, puls, BP, glucose, liquid

  • Treatment according to symptoms
  • Pathogen therapy

penicillin or erythromycin or cefotomycin

adult: 5-7d; child: 10d

  • Complications therapy
  • Carrier penicillin 7days
prevention
Prevention
  • Control the source of infection isolation patient, treat carriers and pharyngitis for 7 days
  • Interruption of route of transmission

mask,disinfect to secrations and infection substances

  • Protect to susceptible populations

no vaccine

  • END