艾滋病发病期舌头症状艾滋病的初期症状舌头( 三 )

【艾滋病发病期舌头症状艾滋病的初期症状舌头】如果由正常无菌部位分离出A组溶血性链球菌，则可确诊中毒性休克综合征。而如果细菌是从正常非无菌部位（如上述案例中的阴道分泌物）分离出来时，则考虑为“诊断可能性大”[7] 。

当舌黏膜受累时，中毒性休克综合征亦可引起草莓样舌炎，其他黏膜表现可能包括阴道黏膜溃疡、结膜充血。

此外，与草莓舌有关的疾病还包括一些罕见的细菌或病毒感染，例如复发性毒素介导性会阴红斑（葡萄球菌和/或链球菌引起的自限性皮肤黏膜感染，常有复发但无多系统受累）、Recalcitrant erythematous desquamating disorder（该病与中毒性休克综合征相似，但不符合后者的诊断标准，且发病率较低、病程较长，常与艾滋病相关）、假结核耶尔森菌感染（Yersinia pseudotuberculosis）、黄热病病毒感染等[4] 。

综上所述，临床医生应重视发热儿童的口腔和舌部检查。当遇到草莓舌时，除了考虑川崎病、猩红热等常见疾病，还应考虑到中毒性休克综合征和一些特殊细菌或病毒感染的可能。
参考文献
[1] Kole A, Chandakole D. IMAGES IN CLINICAL MEDICINE. Strawberry Tongue. N Engl J Med. 2015 Jul 30;373(5):467. doi: 10.1056/NEJMicm1411222. PMID: 26222562.
[2] Mahajan VK, Sharma NL. Scarlet fever. Indian Pediatr. 2005 Aug;42(8):829-30. PMID: 16141487.
[3] Contou D, Emery M, Cecchini J, Flamarion E, Guillaud C, Mekontso Dessap A. Young Woman With Strawberry Tongue. Ann Emerg Med. 2017 Mar;69(3):293-307. doi: 10.1016/j.annemergmed.2016.09.022. PMID: 28231985.
[4] Adya KA, Inamadar AC, Palit A. The strawberry tongue: What, how and where?. Indian J Dermatol Venereol Leprol 2018;84:500-5
[5] https://www.uptodate.com/contents/zh-Hans/complications-of-streptococcal-tonsillopharyngitis/print?sectionName=%E7%8C%A9%E7%BA%A2%E7%83%AD&search=prevention-and-treatment-of-measles&topicRef=3021&anchor=H4&source=see_link#H4
[6]American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Council on Epidemiology and Prevention. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation. 2017 Apr 25;135(17):e927-e999.
[7]CDC. Streptococcal Toxic Shock Syndrome. Available from: https://www.cdc.gov/groupastrep/diseases-hcp/Streptococcal-Toxic-Shock-Syndrome.html
[8]Dong Y, Wang L, Burgner DP, Miller JE, Song Y, Ren X, Li Z, Xing Y, Ma J, Sawyer SM, Patton GC. Infectious diseases in children and adolescents in China: analysis of national surveillance data from 2008 to 2017. BMJ. 2020 Apr 2;369:m1043. doi: 10.1136/bmj.m1043. PMID: 32241761; PMCID: PMC7114954.

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艾滋病发病期舌头症状 艾滋病的初期症状舌头( 三 )

艾滋病发病期舌头症状艾滋病的初期症状舌头( 三 )