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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. Hemolytic streptococcus B group A Acute respiratory infectious disease

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SCARLET FEVER

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  1. SCARLET FEVER Definition Etiology Epidemiology Pathogenesis and pathology Clinical manifestation Laboratory findings Complications Diagnosis and Different Diagnosis Treatment Prevention

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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,

  8. 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

  9. 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

  10. type • Septic type • Toxic type • Surgical or puerperal type • Mild type • Typical type

  11. Complications • Rheumatic fever • Glumerulonephritis • Arrhritis

  12. Laboratory findings • Blood Routine:WBC10-20X109/L,N>80% • Urine Rt: protein uria ,cast renal complication • Bacteriological examination: swab or secretion-culture • Dick test:

  13. 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

  14. 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

  15. 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

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