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Visiting the Doctor

猩 红 热 Scarlet fever. 北京大学第三医院 崔蕴璞. Visiting the Doctor. Your subtitle goes here. Contents. 1. Etiology. 2. Epidemiology. 3. Clinical Manifestations. 3. Clinical Manifestations. 4 . Differential Diagnosis. Etiology. Group A hemolytic streptococcal pyogenes. GAS.

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Visiting the Doctor

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  1. 猩 红 热 Scarlet fever 北京大学第三医院 崔蕴璞 Visiting the Doctor Your subtitle goes here

  2. Contents 1. Etiology 2. Epidemiology 3. Clinical Manifestations 3.Clinical Manifestations 4. DifferentialDiagnosis

  3. Etiology Group A hemolytic streptococcal pyogenes. GAS

  4. 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

  5. Contents 1. Etiology 2. Epidemiology 3. Clinical Manifestations 4. DifferentialDiagnosis

  6. Epidemiology

  7. Epidemiology 传染源： • 患者 • 健康带菌者

  8. Epidemiology 传播途径： • 呼吸道飞沫 • 食物、玩具间接经口 • 皮肤伤口

  9. Epidemiology 易感人群： • 3~7岁儿童

  10. Epidemiology 流行季节: Spring Winter

  11. Contents 1. Etiology 2. Epidemiology 3. Clinical Manifestations 3.Clinical Manifestations 4. DifferentialDiagnosis

  12. 分 期 • Incubation period 潜伏期 • Prodromal period 前驱期 • Rash period 出疹期 • Convalescent period 恢复期

  13. Incubation period 1~7days,mean 3days No symptoms and signs

  14. Common Type • Incubation period • Prodromal period • Rash period • Convalescent period

  15. Prodromal period Fever Headache Abdominal pain Swollen glands in the neck Sore throat White strawberry tongue

  16. Prodromal period Purulent tonsillitis

  17. Prodromal period White Strawberry tongue Normal tongue

  18. Common Type • Incubation period • Prodromal period • Rash period • Convalescent period

  19. Rash period Rash appears Whithin 24 ~48h after onset of fever Pastia’s lines In 12~24h diffused to the whole body

  20. Pastia’s lines

  21. Modality of the rash Sunburn with goose pimples a difffuse,fine papular

  22. Touch of the rash fine sandpaper

  23. Circumoral pallor

  24. Red Strawberry tongue By the 3rd or 4th day the white coat peel off

  25. Common Type • Incubation period • Prodromal period • Rash period • Convalescent period

  26. Convalescent period Rash begin to fade at the end of the 1st week Rash Vanish in 2~4 days

  27. 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

  28. Desquamation usually the last to desquamate not until the 2nd or 3rd week

  29. Desquamation

  30. Desquamation

  31. Characteristic Manifestations Fever Typical rash Strawberry tongue Pastia’s lines Circumoral pallor Desquamation

  32. Contents 1. Etiology 2. Epidemiology 3. Clinical Manifestations 4. DifferentialDiagnosis

  33. Differential diagnosis • Rubella 风疹

  34. Differential diagnosis • Measles 麻疹

  35. Differential diagnosis • Varicella 水痘

  36. 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

  37. 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.

  38. 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

  39. 猩红热歌谣 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。

  40. THANK YOU 崔蕴璞email:jessypupu@sina.com.cn Tele:13521024549

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