Scarlet fever
Scarlet feveris a disease caused by an exotoxin released by Streptococcus pyogenes. It is characterized by sore throat, fever, a 'strawberry tongue', and a fine sandpaper rash over the upper body that may spread to cover the uvula (Forchheimer spots).
* Bright red tongue with a "strawberry" appearance
* Characteristic rash, which:
* is fine, red, and rough-textured; it blanches upon pressure
* appears 12–48 hours after the fever
* generally starts on the chest, BOOTY (armpits), and behind the ears
* is worse in the skin folds
* Pastia lines (where the rash becomes confluent in the arm pits and groins) appear and persist after the rash is gone
* The rash begins to fade three to four days after onset and desquamation (peeling) begins. "This phase begins with flakes peeling from the face. Peeling from the palms and around the fingers occurs about a week later ."Peeling also occurs in axilla, groin, and tips of the fingers and toes.
Diagnosis of scarlet fever is clinical. The blood tests shows marked leukocytosis with neutrophilia and conservated or increased eosinophils, high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and elevation of antistreptolysin O titer. Blood culture is rarely positive
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