Visiting the Doctor - 北京大学第三医院.PPT

Visiting the Doctor Your subtitle goes here Etiology Group A hemolytic streptococcal pyogenes. 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 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 Epidemiology 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 Common Type Incubation period Prodromal period Rash period Convalescent period Rash period Common Type Incubation period Prodromal period Rash period Convalescent period Characteristic Manifestations Fever Typical rash Strawberry tongue Pastia’s lines Circumoral pallor Desquamation Differential diagnosis Rubella 风疹 Differential diagnosis 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 Desquamation 2. Epidemiology Contents 1. Etiology 4. Differential Diagnosis 3. Clinical Mani