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Scarlet Fever
Case
Patient no. 1Oyugerel a 4 year old girl was brought in on ambulance with a high fever and rashes spreading from face throughout the entire body. The throat showed the symptoms of soreness and pain.
Patient no. 2Batdorj is a 4 year old boy was brought in by ambulance with the complaint of fever, rashes spreading from face to chest and neck. Showed additional symptoms of losing an appetite and vomiting a day prior.
Additional information
• G. Oyugerel• 4 years old• Does not attend
kindergarten • Was admitted on
19.03.15 17:15
• B. Batdorj• 4 years old• Goes to kindergarten• Was admitted on
13.03.15 16:00• Has tonsillitis
Physical Examination Findings• Respiratory rate 26/min• Heart rate 96/min• Reddened cheeks • Small, spotted blot like, red rashes
on the face, neck, trunk and extremities
• Rashes were itchy• Crimson lips• Circumorial pallor• Reddened tongue and tonsils• Coating on the tongue which
disappeared after a day of treatment
• Started with the fever of 39.5° C
• Respiratory rate 20/min• Heart rate 88/min• Reddened cheeks• Small, blot like, multiple red
rashes on face, and entire body• Circumorial pallor• The rashes are rough on the
touch• Rashes were itchy• Reddened tongue• A fever of 38.9° C prior to the
admittance
Progression 18.03.15 – faint red marks on the neck19.03.15 morning – fever reached 39.5° C,
red rashes starting from the neck (there’s a blood from scratching)
19.03.15 17:15 – admitted into the hospital
19.03.15 evening – entire body is covered in the rashes
19-20.03.15 – the coating on the tongue fades after the treatment
18-22.03.15 – the fever of 38° C persists through the nights
20-22.03.15 - rashes begin to disappear by peeling off of the skin (desquamation)
22.03.15 afternoon – a slight soreness in the mouth still remains
11.03.15 evening – fever of 38.9° C, vomiting, headache
12.03.15 afternoon – face redness, rashes begin to spread down neck to the chest and entire body, tongue is red. Ambulance.
13.03.15 – admitted into hospital17-18.03.15 – the rash begins to
lessen and thin (desquamation, starting from the fingertips)
19-20.03.15 – lessens further21-22.03.15 - the rash is gone but the
skin of the leg still remains a bit rough (like a sandpaper)
Laboratory TestingSG 1.015 1.015
PH 5 5
LEU 500/µl 3+
NIT Neg Neg
PRO 25 mg/dl 1+
GLU Norm Neg
KET 50 mg/dl 3+
UBG Norm Neg
BIL Neg Neg
ERY 10/µl 1+
Color Yellow
Clarity clear
Laboratory Testing (changes)HCT 31.3 35.0-55.0
MPV 7.2 8.0-11.0
WBC 25.4 3.5-10.0
HGB 10.8 11.5-16.5
GRAN 23.7 1.2-8.0
LYM% 4.4 15.0-50.0
GRA% 93.2 35.0-80.0
RDW% 17.0 11.0-16.0
MPV 6.7 7.0-11.0
WBC 11.1 3.5-10.0
GRAN 8.3 1.2-8.0
Treatment
• Ampicillin injections• Nurofeni• Chlorphenamini• Ascorutini• Viferoni (suppositorium)• Tamedini• Paracetamol
• Ampicillin injections• Chlorphenamini• Groprinosini• Ascorutini• Tamedini