Image from page 291 of "Diseases of children for nurses" (1911)
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ises abruptly, reachingthe maximum temperature of 1040 F. to 105° F. in twenty-four or forty-eight hours, and remaining at about thisheight for three or four days and then falling by lysis.The duration of the febrile period is from seven to ninedays. The pulse is rapid, out of all proportion to thefever, and the respirations are accelerated. The appetiteis lost, the bowels are constipated, and the urine is scantyand high colored and often contains albumin. Nervous Symptoms.—Restlessness, headache, insomnia,delirium, and convulsions may occur. Convulsions occur-ring late in the disease are very significant of uremia. More Severe Cases.—Anginoid Scarlet Fever.—Thisform is characterized by severe throat symptoms. Thetonsils are much swollen and often covered with a falsemembrane. The fever is high and the prostration isprofound. Ulceration, and, at times, gangrene of thethroat occur; the carotid artery may be involved. In thisform death may result from exhaustion, aspiration pneu-
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The eruption of scarlet fever on the third day (Hecker, Trumpp and Abt). CONTAGIOUS DISEASES 287 monia, or hemorrhage from an ulceration of the carotidartery. Malignant Scarlet Fever.—This is a very severe form ofthe disease. The onset is abrupt, with a chill, vomiting ora convulsion. The fever is very high (106° F. to 107° F.).The pulse is rapid and feeble. Delirium sets in and isfollowed by coma. Death may result before the appear-ance of the rash in twenty-four or forty-eight hours. Therash, if present, may become hemorrhagic. Complications.—Nephritis.—This usually developsduring convalescence and, as it may be unattended bysubjective symptoms, the urine in a case of scarlet fevershould be examined daily in order to detect immediatelythe presence of albumin. In other cases the onset ofnephritis is recognized by the suppression of urine, thedevelopment of uremia, and the appearance of dropsy. Nephritis may be the immediate cause of death, butmore commonly the case ends in re
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