Scarlet Fever (Scarlatina): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
    • Inspection (viewing).
      • Skin, mucous membranes, mouth, throat, and tongue [maculopapular (fine-spotted) exanthema (begins on neck and extends to extremities (hands and feet are left out); after exanthema disappears, skin peels); whitish coated tongue (early phase of infection); strawberry or raspberry tongue (late phase of infection); perioral pallor (pale skin around mouth)] [due todifferential diagnoses: erythema infectiosum (ringworm); morbilli (measles); rubella (rubella)]
    • Auscultation (listening) of the heart [due topossible secondary diseases: Endocarditis (meningitis); Myocarditis (inflammation of the heart muscle); Pericarditis (inflammation of the pericardium)]
    • Examination of the lungs
      • Auscultation (listening) of the lungs
      • Bronchophony (checking the transmission of high-frequency sounds; the patient is asked to pronounce the word “66” several times in a pointed voice while the doctor listens to the lungs)[increased sound conduction due to pulmonary infiltration/compaction of lung tissue (e.g., in pneumonia) the consequence is, the number “66” is better understood on the diseased side than on the healthy side; in the case of reduced sound conduction (attenuated or absent: e.g., in pleural effusion). The result is, the number “66” is barely audible to absent over the diseased part of the lung, because the high-frequency sounds are strongly attenuated]
      • Voice fremitus (checking the transmission of low frequencies; the patient is asked to say the word “99” several times in a low voice, while the doctor puts his hands on the chest or back of the patient)[increased sound conduction due to pulmonary infiltration / compaction of lung tissue (eg, in pneumonia) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; in the case of reduced sound conduction (greatly attenuated or absent: in pleural effusion). The consequence is, the number “99” is barely audible to absent over the diseased part of the lung, because the low-frequency sounds are strongly attenuated]
    • Palpation (palpation) of the abdomen (abdomen), the kidney bearings (pressure pain?, knock pain?, cough pain?, defensive tension?, hernial gates?, kidney bearing knock pain?) [abdominal pain (abdominal pain), acute glomerulonephritis – kidney disease, with inflammation of the renal filterlets (glomeruli) (possible secondary disease)]
  • ENT medical examination – if sinusitis (sinusitis) or otitis media (middle ear infection) is suspected.

Square brackets [ ] indicate possible pathological (pathological) physical findings.