Scarlet fever case study

1. Scarlet Fever

2. Case
Patient no. 1
Oyugerel 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. 2
Batdorj 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.

3. 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

4. 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

5. Progression
18.03.15 – faint red marks on the neck
19.03.15 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 hospital
17-18.03.15 – the rash begins to lessen
and thin (desquamation, starting
from the fingertips)
19-20.03.15 – lessens further
21-22.03.15 - the rash is gone but the
skin of the leg still remains a bit
rough (like a sandpaper)

6. Laboratory Testing
SG 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

7. 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

8. Treatment
• Ampicillin injections
• Nurofeni
• Chlorphenamini
• Ascorutini
• Viferoni
(suppositorium)
• Tamedini
• Paracetamol
• Ampicillin injections
• Chlorphenamini
• Groprinosini
• Ascorutini
• Tamedini