Transcript 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
 Clinical features:Fever ,pharyngitis,
genernal diffused fresh red eruption and
obvious desquamation
 Complication:heart,kidney and joints
diseases
 return
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.
 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
 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
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
 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 substancesgeneral toxic symptoms:fever, headache and bad
appeptite,
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
 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
type
 Septic type
 Toxic type
 Surgical or puerperal type
 Mild type
 Typical type
Complications
 Rheumatic fever
 Glumerulonephritis
 Arrhritis
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
 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
 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
 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