Far East scarlet-like fever
- History 1
- Etiology 2
- Pathophysiology 3
Clinical features 4
- Diferential diagnosis 4.1
- References 5
The cause of this disease is Yersinia pseudotuberculosis serotype O1. 95% are subtype O1b.
Yersinia pseudotuberculosis has been divided into 6 genetic groups: group 1 has only been isolated from the Far East.
The clinical features of this disease appear to be due—at least in part—to the production of a superantigen—YpM (yersina pseudotuberculosis-derived mitogen). This is present in almost all strains from the Far East but only 20% of European isolates. The antigen was discovered in 1993 and is encoded by a 456 base gene. The protein has 151 amino acids with a signal sequence of 20 amino acids. The mitogenic antigens are scattered across the protein but two cysteine residues (residues 32 and 129) which form a disulphide bridge are critical.
The bacteriophage given the nearby presence of a phage integration site but the mechanism of entry into the genome is not currently known.
- erythematous skin rash usually of the face, elbows and knees
- skin desquamation
- hyperaemic tongue
- toxic shock syndrome
Relapses occur in up to 50% of patients.
The main differential diagnosis is scarlet fever.
- Sato K, Ouchi K, Taki M (1983) Yersinia pseudotuberculosis infection in children, resembling Izumi fever and Kawasaki syndrome. Pediatr Infect Dis 2: 123–126
- Fukushima H Matsuda Y, Seki R, Tsubokura M, Takeda N, Shubin FN, Paik IK, Zheng XB (2001) Geographical heterogeneity between Far Eastern and Western countries in prevalence of the virulence plasmid, the superantigen Yersinia pseudotuberculosis-derived mitogen, and the high-pathogenicity island among Yersinia pseudotuberculosis strains. J Clin Microbiol 39:3541–3547
- Yoshino K, Ramamurthy T, Nair GB, Fukushima H, Ohtomo Y, Takeda N, Kaneko S, Takeda T (1995) Geographical heterogeneity between Far East and Europe in prevalence of ypm gene encoding the novel superantigen among Yersinia pseudotuberculosis strains. J Clin Microbiol 33(12) 3356–3358
- Zalmover IIu, Znamenskiĭ VA, Ignatovich VO, Vishniakov AK, Serov GD (1969) Clinical aspects of Far Eastern scarlatina-like fever. Voen Med Zh 1:47–51
- Solozhenkin VG (1978) Scarlet fever-like disease in children. Pediatriia (1):27–28
- Antonov VS (1978) Differential diagnosis of scarlet fever-like forms of pseudotuberculosis and scarlet fever in children. Pediatriia 52(1):6–9