5.5.

 PMHPregnancy : normal , no drugs taken.Perinatal: normal,

no complications.Delivery: no complications.Postnatal: no
complications.Infancy: repetitive upper respiratory tract
infections.Development: Normal development. Walked when he
was able to stand with help at 1 yr , able to walk at 1 ,
5/12yrsImmunizations: up to date.Surgical Hx: Orchidopexia ,
due to undescended testis at 1 yrMedical Hx: nothing reported
by parentsMed: nil regAllergies: none known.
6.6. FH-2 Older sisters healthy.-No one in the family with
similar symptoms.-Father: cardiac problems and high
cholesterol on father family line.-Mother: (-)SH-He currently
attends school on yr 1-No problems with school, no problems
socialising “he’s actually a very popular kid”-No problems at
home reported.-No recent travel-No pets
7.7. S/R-General: looking poorly for last 4 days, feeding ok and
drinking ok , despite vomiting.-ENT: dry cough before the
episode of rash + fever , swollen tonsils, difficulties with
swallowing.-GI: diarrhoea-RS: no asthma , no SOB, no
palpitations-CVS: (-)-GUS: urine colour changes-NS: (-)-MSS:
pain in hand bilaterally ,-SKIN: raised skin temperature +
swelling, itchy maculopapular rash.
8.8. O/E-General: alert , responsive cooperative child to
examination38 C-RS: (-)-CVS: (-) no cyanosis, no clubbing, no
SOB, no murmurs.-ENT: inflamed red throat, red swollen
tongue, no palate erythema, ears: L=clear R= waspy , tonsils
Treated with Antibiotic.
4.14. Scarlet FeverCLINICAL FEATURES- 2-4 incubation
period- Headache and tonsillitis appear after- Rash develops
within 2 hours- Spreads rapidly over trunk and neck- With
increased density in the neck, axillae and groins.
5.15. Scarlet Fever. CLINICAL FEATURES - A fine punctuate
erythematous appearance - A “sand papery” feel. - And
blanching on pressure. - Tongue white first then “red
strawberry” - Rash lasts about 6 days followed by peeling
6.16. Scarlet Fever. INVESTIGATIONS - Throat swab mat
show group A streptococcus - Antistreptolysin ( ASO ) titre is
high.
7.17. Scarlet Fever. MANAGEMENT - 10- day course of
penicillin V or erythromycin - Isolation: children should be
isolated until 24th after the start of antiibiotics - Antibiotic
prevents other children from being infected and reduce lenght
of illness. - Should be started within 9 days of acute illness. -
Follow updated hospital guidelines if at all any.
8.18. Scarlet Fever. COMPLICATIONS Peritonsilar abscess
Retropharyngeal abscess Acute Glomerulonephritis (2 weeks)
Rheumatic fever Pneumonia Meningitis / Brain absses
(incidence) Sepsis
9.19. Scarlet Fever
10.20. References Rudolf M, Lee T, Levene M. Paediatrics
and Child Health. Wiley Blackwell, 2001; 3rd ed. Lissauer T,