113例儿童猩红热临床特征分析

Clinical Analysis of 113 Cases with Scarlet Fever in Children

摘要: 目的：分析近年儿童猩红热的临床特征。方法：对113例有发热皮疹等临床表现并经咽拭子培养A组β型溶血性链球菌阳性的儿童猩红热确诊病例的临床特征进行回顾性分析。结果：113例患儿中男70例，女43例，4~7岁年龄段儿童占77.9%；90例有发热，占79.6%；全部患儿均有皮疹，典型充血性鸡皮样粟粒疹73例(64.6%)，口腔黏膜明显充血83例(73.4%)，口周苍白圈14例(12.4%)，巴氏线20例(17.7%)；皮疹以躯干部位最为常见，占91.2%；首诊临床诊断为“猩红热”14例；全部患儿均未出现严重并发症表现。结论：学龄前期及学龄期儿童是猩红热的高发人群，临床症状趋于轻症化、不典型化，临床缺少快速实验室诊断方法，易延误早期临床诊治。除典型皮疹外，口腔黏膜明显充血可能是猩红热的早期表现之一，可进一步深入研究。

Abstract: Objective: To analyze the clinical features of scarlet fever in children. Methods: The medical rec-ords of 113 cases with fever and erythema that had been confirmed scarlet fever by bacterial culture of throat swab were analyzed retrospectively. Results: In total, 113 cases of scarlet fever in children with etiological diagnosis were analyzed, including 70 males and 43 females. Age distribution ranged from 1 to 12 years, including 88 cases (77.9%) of 4 - 7 years old group. 90 cases (79.6%) have fever. All have erythema and 73 cases (64.6%) with the typical congestive chicken- skin miliary erythema. 83 cases (73.4%) have obviously congestion on oral mucosa; 14 cases (12.4%) have cicumoral pallor and 20 cases (17.7%) have Pastia’s lines. 103 cases (91.2%) have erythema at trunk. 14 cases of primary diagnosis have scarlet fever. There is no severe complication in all cases. Conclusions: The high risk populations of scarlet fever are pre-school and school children. The clinical symptoms tend to slightly and atypical. There are no rapid laboratory methods to diagnose, and hardly to diagnose and treat early. Obviously congestion on oral mucosa is an early clinical manifestation of scarlet fever except for typical erythema, and should be intensely researched.