SCARLET FEVER. Synonyms.—Scarlatina; Scarlet Rash. Definition ...

the gonococcus, the bacillus coli communis, bacillus typhosis, bacillus
pyocyaneus, and many other specific micro-organisms.
These pyogenic organisms, either by their specific action or by the toxins
they produce, cause coagulation-necrosis of the neighboring tissue cells,
and as this process extends, inflammation of the veins and other vessels
takes place; as a result of this inflammatory action, the endothelium
becomes detached, and, with its contained micrococci, is floated off by
the blood-stream. In its course they reach some part of the circulatory
system, where, owing to its diminished size, they can not pass through;
as a result, the embolus thus obstructs the vessel, stasis occurs, and,
when the soil is suitable, these micro-organisms set up new suppurating
centers.
Pathology.—The cadaver, strange to say, does not undergo
putrefaction as rapidly as in septicemia. The first effects of the morbid
changes are found in the veins, which result in thrombi. These float off
and are found in the lungs, liver, spleen, kidneys, brain, and, in fact,
the various organs and tissues of the body. These thrombi, rich in microorganisms,
suppurate, and thus the so-called metastatic abscesses are
formed.
The location of these abscesses depends, to some extent, upon the site of
the primary focus. Thus, if it be in the region drained by the portal
circulation, the liver would be the seat of these necrotic spots. If an
ulcerative endocarditis be the seat of the primary lesion, the secondary
abscesses will be found in the lung, spleen, kidneys, brain, intestines,
and skin. These abscesses are usually small, though a coalescence of
several of them may form quite a large cavity.
A favorable seat for the primary foci, when not traumatic, is the
subcutaneous cellular tissue; the pelvic cellular tissues and organs; the
marrow of the long bones; the neighboring tissues of the middle ear
cavity; the joints, and, as already stated, an ulcerative endocarditis.
Symptoms.—The symptoms of pyemia vary greatly in different cases,
depending, to a great extent, upon the local lesions, though the general
symptoms will be similar in all cases.
Incubation.—Since the disease is secondary to suppuration in some part
of the body, morbid changes have been going on for several days before
the pyemic state is reached. From five to ten days after the reception of
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 175