On examination, the child was mildly icteric with a strawberry tongue, exudative pharyngitis and circumoral pallor
. Besides the typical rash suggestive of scarlet fever, other systemic examination was unremarkable.
A clinical case of scarlet fever is defined as acute illness onset with fever, pharyngitis, and sandpaper-like red rash with or without strawberry tongue, Pastia lines, or circumoral pallor
. In China, clinicians and hospitals are to report clinical cases of scarlet fever to NNIDSS within 6 hours of diagnosis.
Whenever I suggest that this number is far too high and propose a 1-to-1 ratio, I see administrators (who despite what I've written here I regard as allies) become wide-eyed and develop circumoral pallor
. As a nation we have far too many ICU beds--about 8% to 12%, or 55 000 beds in 6000 ICUs.
Typically, there is less involvement around the mouth causing a typical "circumoral pallor
," pale color skin around the mouth surrounded by a flushed face.