猩红热4 visiting the 课件

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1、VisitingtheDoctorYoursubtitlegoeshere猩红热Scarletfever北京大学第三医院崔蕴璞2.EpidemiologyContents1.Etiology4.DifferentialDiagnosis3.ClinicalManifestations3.ClinicalManifestationsGroupAhemolyticstreptococcalpyogenes.EtiologyGASExtracellularEnzymesandToxins:Streptococcalpyogenicexotoxins(SPE)红疹

2、毒素StreptolysinOandS溶血素Streptokinase(SK)链激酶DNAasesDNA酶Hyaluronidase透明质酸酶Proteinase蛋白酶2.EpidemiologyContents1.Etiology4.DifferentialDiagnosis3.ClinicalManifestationsEpidemiologyEpidemiology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岁儿童流行季节:EpidemiologyWinterSp

3、ring2.EpidemiologyContents1.Etiology4.DifferentialDiagnosis3.ClinicalManifestations3.ClinicalManifestations分期Incubationperiod潜伏期Prodromalperiod前驱期Rashperiod出疹期Convalescentperiod恢复期Incubationperiod1~7days,mean3daysNosymptomsandsignsCommonTypeIncubationperiodProdromalperiodRashperio

4、dConvalescentperiodProdromalperiodFeverHeadacheAbdominalpainSwollenglandsintheneckSorethroatWhitestrawberrytongueProdromalperiodPurulenttonsillitisProdromalperiodWhiteStrawberrytongueNormaltongueCommonTypeIncubationperiodProdromalperiodRashperiodConvalescentperiodRashperiodRashapp

5、earsWhithin24~48hafteronsetoffeverIn12~24hdiffusedtothewholebodyPastia’slinesPastia’slinesModalityoftherashadifffuse,finepapularSunburnwithgoosepimplesTouchoftherashfinesandpaperCircumoralpallorRedStrawberrytongueBythe3rdor4thdaythewhitecoatpeeloffCommonTypeIncubationperiodProdrom

6、alperiodRashperiodConvalescentperiodConvalescentperiodRashVanishin2~4daysRashbegintofadeattheendofthe1stweekDesquamationattheendofthe1stweektothe2ndweekdesquamationoccurcomesoffasfineflakeslikebran糠屑样脱皮Desquamationusuallythelasttodesquamatenotuntilthe2ndor3rdweekDesquamationDesqua

7、mationCharacteristicManifestationsFeverTypicalrashStrawberrytonguePastia’slinesCircumoralpallorDesquamation2.EpidemiologyContents1.Etiology4.DifferentialDiagnosis3.ClinicalManifestationsDifferentialdiagnosisRubella风疹Measles麻疹DifferentialdiagnosisVaricella水痘DifferentialdiagnosisCas

8、eAsevenyearoldboypresentswithfeve