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1.
J Chem Ecol ; 2024 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-38760625

RESUMEN

Insecticide toxicity to insect herbivores has long been known to vary across different host plants; this phenomenon has been widely documented in both foliage-feeders and sap-feeders. Species-specific phytochemical content of hostplant tissues is assumed to determine the pattern of induction of insect enzymes that detoxify insecticides, but specific phytochemicals have rarely been linked to host plant-associated variation in pesticide toxicity. Moreover, no studies to date have examined the effects of nectar source identity and phytochemical composition on the toxicity of insecticides to pollinators. In this study, we compared LD50 values for the insecticide bifenthrin, a frequent contaminant of nectar and pollen in agroecosystems, in the western honey bee, Apis mellifera, consuming three phytochemically different monofloral honeys: Nyssa ogeche (tupelo), Robinia pseudoacacia (black locust), and Fagopyrum esculentum (buckwheat). We found that bifenthrin toxicity (LD50) values for honey bees across different honey diets is linked to their species-specific phytochemical content. The profiles of phenolic acids and flavonoids of buckwheat and locust honeys are richer than is the profile of tupelo honey, with buckwheat honey containing the highest total content of phytochemicals and associated with the highest bifenthrin LD50 in honey bees. The vector fitting in the ordination analysis revealed positive correlations between LD50 values and two honey phytochemical richness estimates, Chao1 and Abundance-based Coverage Estimator (ACE). These findings suggest unequal effects among different phytochemicals, consistent with the interpretation that certain compounds, including ones that are rare, may have a more pronounced effect in mitigating pesticide toxicity.

2.
World J Diabetes ; 15(3): 440-454, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38591075

RESUMEN

BACKGROUND: Patients with diabetes mellitus (DM) are predisposed to an increased risk of infection signifying the importance of vaccination to protect against its potentially severe complications. The Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices (CDC/ACIP) issued immunization re-commendations to protect this patient population. AIM: To assess the adherence of patients with DM to the CDC/ACIP immunization recommendations in Saudi Arabia and to identify the factors associated with the vaccine adherence rate. METHODS: An observational retrospective study conducted in 2023 was used to collect data on the vaccination records from 13 diabetes care centers in Saudi Arabia with 1000 eligible patients in phase I with data collected through chart review and 709 patients in phase II through online survey. RESULTS: Among participants, 10.01% (n = 71) had never received any vaccine, while 85.89% (n = 609) received at least one dose of the coronavirus disease 2019 (COVID-19) vaccine, and 34.83% (n = 247) had received the annual influenza vaccine. Only 2.96% (n = 21), 2.11% (n = 15), and 1.12% (n = 8) received herpes zoster, tetanus, diphtheria, and pertussis (Tdap), and human papillomavirus (HPV) vaccines, respectively. For patients with DM in Saudi Arabia, the rate of vaccination for annual influenza and COVID-19 vaccines was higher compared to other vaccinations such as herpes zoster, Tdap, pneumococcal, and HPV. Factors such as vaccine recommendations provided by family physicians or specialists, site of care, income level, DM-related hospitalization history, residency site, hemoglobin A1c (HbA1c) level, and health sector type can significantly influence the vaccination rate in patients with DM. Among non-vaccinated patients with DM, the most reported barriers were lack of knowledge and fear of side effects. This signifies the need for large-scale research in this area to identify additional factors that might facilitate adherence to CDC/ACIP vaccine recommendations in patients with DM. CONCLUSION: In Saudi Arabia, patients with DM showed higher vaccination rates for annual influenza and COVID-19 vaccines compared to other vaccinations such as herpes zoster, Tdap, pneumococcal, and HPV. Factors such as vaccine recommendations provided by family physicians or specialists, the site of care, income level, DM-related hospitalization history, residency site, HbA1c level, and health sector type can significantly influence the vaccination rate in patients with DM.

3.
FEMS Microbes ; 5: xtae002, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38450098

RESUMEN

Container aquatic habitats host a community of aquatic insects, primarily mosquito larvae that browse on container surface microbial biofilm and filter-feed on microorganisms in the water column. We examined how the bacterial communities in these habitats respond to feeding by larvae of two container-dwelling mosquito species, Culex pipiens and Cx. restuans. We also investigated how the microbiota of these larvae is impacted by intra- and interspecific interactions. Microbial diversity and richness were significantly higher in water samples when mosquito larvae were present, and in Cx. restuans compared to Cx. pipiens larvae. Microbial communities of water samples clustered based on the presence or absence of mosquito larvae and were distinct from those of mosquito larvae. Culex pipiens and Cx. restuans larvae harbored distinct microbial communities when reared under intraspecific conditions and similar microbial communities when reared under interspecific conditions. These findings demonstrate that mosquito larvae play a major role in structuring the microbial communities in container habitats and that intra- and interspecific interactions in mosquito larvae may shape their microbiota. This has important ecological and public health implications since larvae of the two mosquito species are major occupants of container habitats while the adults are vectors of West Nile virus.

4.
Ecol Evol ; 14(2): e10918, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38389995

RESUMEN

Aspergillus fungi are ubiquitous inhabitants of colonies of the western honey bee (Apis mellifera), where they interact with bees in associations ranging from parasitism to possible mutualism. Aspergillus Flavi fungi are frequently found in bee bread (pollen processed for longterm storage) and are thought to contribute to food preparation, processing, preservation, and digestion. Conditions in the hive are challenging for fungi due, in part, to xeric and acidic properties of bee bread and the omnipresence of propolis, an antimicrobial product manufactured by bees from plant resins. We used quantitative and qualitative assays to determine whether A. flavus isolated from bee bread demonstrates tolerance for hive environmental conditions in terms of temperature, pH, osmotic pressure, and propolis exposure. Comparisons made use of three strains of A. flavus: a fungal biocontrol product not known from beehives (AF36), a strain isolated from bee bread (AFBB) in hives from central Illinois, and a pathogenic strain from a honey bee colony displaying symptoms of stonebrood (AFPA). Strain AFBB displayed higher tolerance of acidic conditions, low matric potential (simulating xeric substrate), and propolis exposure than did other strains. A genomic comparison between this new strain and the reference NRRL-3357 showed that AFBB, like AF36, might be blocked from carrying out aflatoxin biosynthesis. Sequence comparisons also revealed several missense variants in genes that encode proteins regulating osmotolerance and osmotic pressure in Aspergillus spp., including SakA, SskB, GfdA, and TcsB/Sln1. Collectively, results of our laboratory assays and genetic analyses are consistent with the suggestion that the strain isolated from bee bread is adapted to the bee bread environment and may have persisted due to a coevolutionary relationship between Aspergillus and A. mellifera. This finding bolsters recent concerns about the effects of fungicide use near bee colonies and broadens the ecological importance of highly adaptable fungal strains.

5.
Org Lett ; 26(14): 2817-2820, 2024 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-38189248

RESUMEN

Catalysis using substoichiometric copper facilitates the synthesis of masked (hetero)aryl sulfinates under mild, base-free conditions from aryl iodides and the commercial sulfonylation reagent sodium 1-methyl 3-sulfinopropanoate (SMOPS). The development of a tert-butyl ester variant of the SMOPS reagent allowed the use of aryl bromide substrates. The sulfones thus generated can be unmasked and functionalized in situ to form a variety of sulfonyl-containing functional groups.

6.
Acta Medica Philippina ; : 1-14, 2024.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1006383

RESUMEN

Background and Objective@#Scabies is the second most common cause of disability due to skin disease in the Philippines. However, there were no cited studies in Global Burden of Disease 2019 and the disability-adjusted life years (DALY) computations were most likely based on statistical modelling. The Philippine Department of Health has embarked on a program to estimate the disease burden of priority diseases in the country, which include scabies. The last nationwide prevalence survey was 23 years ago. This systematic review aimed to estimate the prevalence or incidence of scabies in the Philippines. @*Methods@#We searched PubMed, Scopus, Herdin, and Philippine Health Research Registry (search date October 2022) for studies on prevalence/incidence (including systematic reviews, cross-sectional studies, cohort studies, case series, registry or census studies) of patients diagnosed with scabies in the Philippines. We excluded narrative reviews, commentaries, and conference proceedings or abstracts. Two reviewers independently screened titles and abstracts, assessed full text reports for eligibility, appraised the quality of included studies, and collected data using a pretested data extraction form. We did not pool studies due to clinical heterogeneity but plotted the individual studies in a forest plot with prevalence estimates and confidence intervals. We reported the median and interquartile range for entire group or relevant subgroups (age, setting) of studies. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of evidence.@*Results@#We included nine studies (N=79,065). Most were clinic-based prevalence studies, retrospective chart reviews, conducted in dermatology outpatient clinics, Metro Manila area, and on pediatric populations. Prevalence of scabies was moderate (i.e., between 2 and 10%), ranging from 2.75% (national prevalence survey) to 6.8% (communitybased review), to high (> 10%) among pediatric patients in clinic-based retrospective chart reviews (29 to 36%) and institution-based surveys (39.0% to 45%), and a tertiary government university training hospital dermatology clinic (22.9%). The most affected age group was from 0 to 14 y/o, while males tended to have a higher prevalence than females. The cooler month of January had higher prevalence than the hotter month of June in one study. @*Conclusion@#Scabies is common in the Philippines, especially among children and elderly in institutional settings, and during the month of January. There is a need to do a national prevalence survey to identify high-risk areas and to monitor the prevalence of scabies, especially in crowded settings and vulnerable populations. This information can be used for estimating the burden of disease for scabies and guide appropriate health resource allocation.


Asunto(s)
Escabiosis , Filipinas , Epidemiología , Prevalencia , Incidencia
7.
J Econ Entomol ; 116(6): 2095-2103, 2023 12 11.
Artículo en Inglés | MEDLINE | ID: mdl-37947189

RESUMEN

The production of almonds and pistachios in California's Central Valley employs insecticides for the management of their primary pest, navel orangeworm. The pyrethroid Bifenthrin is commonly used, and now a strain of Amyelois transitella Walker (Lepidoptera: Pyralidae) (R347) obtained from Kern County almond orchards with a history of Bifenthrin use has acquired >110-fold resistance toward pyrethroids. One method to improve control is to use additives and spray adjuvants, which are applied simultaneously with an insecticide to increase coverage and/or duration of control. We tested 2 levels of the naturally occurring clay Kaolin as an additive, alone and in combination with either Bifenthrin or the diamide Chlorantraniliprole, to determine if it could reduce feeding damage and decrease survival of pyrethroid-resistant A. transitella on almonds in the laboratory and improve the efficacy of Chlorantraniliprole in the field. Larval performance was measured for the strains R347 and ALM (34.7-fold resistance compared to susceptible lab strain) reared on treated almonds. Strain R347 had 1.9-fold greater survival and caused 1.3-fold more feeding damage than strain ALM across all treatments, although both strains were susceptible to the combination of Kaolin + insecticide. Kaolin synergized Bifenthrin for R347, decreasing survival by 10.0%. Kaolin did not reduce feeding damage for either strain. When combined with insecticide, feeding damage was similar to insecticide alone, but the addition of Kaolin to the insecticide generally decreased survival more than the insecticide alone. In the field, the addition of Kaolin to Chlorantraniprole during application helped retain activity against this challenging pest.


Asunto(s)
Insecticidas , Mariposas Nocturnas , Prunus dulcis , Piretrinas , Animales , Insecticidas/farmacología , Caolín/farmacología , Resistencia a los Insecticidas , Piretrinas/farmacología
8.
Proc Natl Acad Sci U S A ; 120(48): e2318980120, 2023 Nov 28.
Artículo en Inglés | MEDLINE | ID: mdl-37991944
9.
Sci Rep ; 13(1): 15577, 2023 09 20.
Artículo en Inglés | MEDLINE | ID: mdl-37730836

RESUMEN

Exposure to agrochemical sprays containing pesticides and tank-mix adjuvants has been implicated in post-bloom mortality, particularly of brood, in honey bee colonies brought into California almond orchards for pollination. Although adjuvants are generally considered to be biologically inert, some adjuvants have exhibited toxicity and sublethal effects, including decreasing survival rates of next-generation queens. Honey bees have a highly developed olfactory system to detect and discriminate among social signals. To investigate the impact of pesticide-adjuvant combinations on honey bee signal perception, we performed electroantennography assays to assess alterations in their olfactory responsiveness to the brood ester pheromone (BEP), the volatile larval pheromone ß-ocimene, and the alarm pheromone 2-heptanone. These assays aimed to uncover potential mechanisms underlying changes in social behaviors and reduced brood survival after pesticide exposure. We found that combining the adjuvant Dyne-Amic with the fungicide Tilt (propiconazole) and the insecticide Altacor (chlorantraniliprole) synergistically enhanced olfactory responses to three concentrations of BEP and as well exerted dampening and compensatory effects on responses to 2-heptanone and ß-ocimene, respectively. In contrast, exposure to adjuvant alone or the combination of fungicide and insecticide had no effect on olfactory responses to BEP at most concentrations but altered responses to ß-ocimene and 2-heptanone. Exposure to Dyne-Amic, Altacor, and Tilt increased BEP signal amplitude, indicating potential changes in olfactory receptor sensitivity or sensilla permeability to odorants. Given that, in a previous study, next-generation queens raised by nurses exposed to the same treated pollen experienced reduced survival, these new findings highlight the potential disruption of social signaling in honey bees and its implications for colony reproductive success.


Asunto(s)
Fungicidas Industriales , Insecticidas , Plaguicidas , Prunus dulcis , Humanos , Abejas , Animales , Feromonas , Adyuvantes Inmunológicos , Adyuvantes Farmacéuticos , Plaguicidas/toxicidad , Ésteres
10.
Molecules ; 28(16)2023 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-37630221

RESUMEN

Cancer has been considered one of the most serious diseases in recent decades. Early diagnosis of cancer is a crucial step for expedited treatment. Ideally, detection of cancer biomarkers, which are usually elevated because of cancer, is the most straightforward approach to detecting cancer. Among these biomarkers, the carcinoembryonic antigen (CEA) is considered one of the most important tumor markers for colorectal cancer. The CEA has also been recognized as a biomarker for other types of cancers, including breast, gastric, ovarian, pancreatic, and lung cancers. Typically, conventional CEA testing depends on immunoassay approaches, which are known to be complex, highly expensive, and time consuming. Accordingly, various types of biosensors have been designed for the detection of cancer biomarkers. The main prerequisites of these biosensors are high sensitivity, fast response, and low cost. Many nanostructures have been involved in the design of biosensors, such as nanoparticles of certain metals and metal oxides that are further functionalized to contribute to the sensing of the biomarkers. Alternatively, metal organic frameworks (MOFs), which are extended crystalline structures comprising metal clusters surrounded by organic linkers, have been shown to be highly promising for the development of biosensors. The 3D structure of MOFs results in a combination of high surface area and high interconnected porosity, which are believed to facilitate their function in the design of a biosensor. This review briefly classifies and describes MOF-based biosensor trials that have been published recently for the aim of detecting CEA.


Asunto(s)
Neoplasias Pulmonares , Estructuras Metalorgánicas , Nanopartículas , Humanos , Antígeno Carcinoembrionario , Biomarcadores de Tumor
11.
Proc Natl Acad Sci U S A ; 120(11): e2302593120, 2023 03 14.
Artículo en Inglés | MEDLINE | ID: mdl-36888652
12.
iScience ; 26(3): 106084, 2023 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-36843853

RESUMEN

The effects of neonicotinoid insecticides (NNIs) on honeybee health are intensely debated, with numerous studies showing negative effects of exposure, while others report no such effects. We carried out experiments to study the genetic and molecular basis of NNI tolerance in honeybees, which may underlie the discrepancies observed in the literature. We discovered that worker survival post-exposure to an acute oral dose of clothianidin is heritable (H 2 = 37.8%). Tolerance to clothianidin was not associated with differences in the expression of detoxification enzymes in our experiments. Instead, mutations in the primary neonicotinoid detoxification genes CYP9Q1 and CYP9Q3 were strongly associated with worker survival post-clothianidin exposure. In some instances, the strong association between CYP9Q haplotypes and worker survival was associated with the protein's predicted binding affinity for clothianidin. Our findings have implications regarding future toxicological studies utilizing honeybees as a model pollinator.

13.
J Chem Ecol ; 48(11-12): 850-866, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36450872

RESUMEN

The genus Depressaria (Lepidoptera: Depressariidae) mostly comprises specialist herbivores with varying capacity for detoxification of defensive phytochemistry. Depressaria depressana, a Eurasian moth recently introduced into North America, is a family-level specialist of the Apiaceae, whose hosts include more than a dozen species in multiple tribes; Depressaria radiella is a super-specialist of Eurasian origin that feeds exclusively on species in the genera Pastinaca and Heracleum throughout its native and introduced range. In eastern North America, it feeds upon Pastinaca sativa, an invasive European species, and Heracleum maximum, a native species. We determined whether differences in furanocoumarin metabolism exist between D. depressana and two isolated populations of D. radiella, feeding exclusively on either P. sativa or H. maximum. We also compared gravimetric estimates of feeding efficiency to assess D. depressana larval performance on different diets. Both populations of D. radiella metabolized furanocoumarins at a greater rate than D. depressana. Although there was no difference in rates of metabolism of linear furanocoumarins in the two populations of D. radiella, individuals collected from H. maximum metabolized angular furanocoumarins more rapidly. The gravimetric assessments of feeding efficiencies revealed that D. depressana exhibited highest efficiencies consuming Daucus carota; moreover, this species survived to pupation consuming fruits of Zizia aurea, an apiaceous species native to North America. Our preliminary phylogenetic analysis, building on an earlier morphological analysis, incorporates mitochondrial cytochrome oxidase subunit 1 data from the BOLD database and revealed that the presence or absence of furanocoumarins is not a strong predictor of species-level evolution in Depressaria.


Asunto(s)
Furocumarinas , Mariposas Nocturnas , Pastinaca , Animales , Furocumarinas/metabolismo , Filogenia , Mariposas Nocturnas/metabolismo , Larva/metabolismo , Dieta , Pastinaca/metabolismo
14.
J Med Screen ; 29(4): 268-271, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36062629

RESUMEN

OBJECTIVE: To summarise and compare the key recommendations on prostate-specific antigen (PSA)-based screening for prostate cancer, and so highlight where more evidence is required to facilitate consistent recommendations. METHODS: The Medline database and websites of 18 national screening organisations and professional associations were searched between January 2010 and November 2020 to identify screening guidelines published in English, considering recent clinical trials. RESULTS: Population-based PSA testing of asymptomatic men is not widely recommended. Guidelines emphasize shared patient-clinician decision making. For 'average-risk' men choosing to be screened, the recommended age varies from 50-55 to 70 years, alongside consideration of life expectancy (ranging from 7-15 years). Screening intervals, when specified, are biennial (most common), annual, or determined from baseline PSA. The earliest age for screening high-risk men (frequently defined as of African descent or with a family history of prostate cancer) is 40 years, but recommendations often defer to clinical judgement. CONCLUSIONS: Population screening of asymptomatic men is not widely recommended. Instead, balancing the potential harms and benefits of PSA testing is endorsed. Variation between guidelines stems from differing interpretations of key trials and could lead to clinician-dependent screening views. The development of clinical decision aids and international consensus on guidelines may help reduce national and international variation on how men are counselled.


Asunto(s)
Antígeno Prostático Específico , Neoplasias de la Próstata , Adulto , Detección Precoz del Cáncer , Humanos , Masculino , Tamizaje Masivo , Neoplasias de la Próstata/diagnóstico
15.
Insects ; 13(9)2022 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-36135490

RESUMEN

Depressaria depressana, the purple carrot seed moth, is a Eurasian species first reported in North America in 2008 and currently undergoing range expansion. This invasion follows that of its Eurasion congener Depressaria radiella (parsnip webworm), first documented in North America 160 years ago. Unlike D. depressana, which utilizes hostplants across multiple tribes of Apiaceae, Depressaria radiella is a "superspecialist" effectively restricted in its native and non-indigenous ranges to two closely related apiaceous genera. We investigated the genetic structure of D. depressana populations across latitudinal and longitudinal gradients in the eastern United States by constructing COI haplotype networks and then comparing these with haplotype networks constructed from available COI sequence data from contemporary European D. depressana populations and from European and North American D. radiella populations. Haplotype data revealed higher genetic diversity in D. depressana, indicating high dispersal capacity, multiple introductions, and/or a genetically diverse founding population. Museum and literature records of D. radiella date back to 1862 and indicate that range expansion to the West Coast required more than 50 years. Higher levels of genetic diversity observed in D. depressana compared to its congener may indicate a greater propensity for dispersal, colonization and establishment in its non-indigenous range.

17.
Proc Natl Acad Sci U S A ; 119(11): e2201928119, 2022 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-35245151
18.
Anaesthesia ; 77(1): 96-104, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34494667

RESUMEN

The decision-to-delivery interval is a widely used term at non-elective caesarean section. While the definition may appear self-evident, there is no universally agreed consensus about when this period begins and ends. We reviewed the literature for original research utilising the terms 'decision-to-delivery', 'decision-to-incision' or 'incision-to-delivery' and examined definitions used for decision, delivery, incision, as well as any additional time intervals that were assessed. Our analysis demonstrated an inconsistent non-standardised approach to defining these intervals, which might have clinical practice and medicolegal ramifications. We propose that the decision-to-delivery interval should be defined as follows: the interval between the time at which the senior obstetrician makes the decision that a caesarean section is required and the time at which the fetus (or first fetus in the case of multiples) is delivered. The decision time should ideally be recorded contemporaneously in the medical notes or partogram.


Asunto(s)
Cesárea/normas , Toma de Decisiones , Femenino , Humanos , Embarazo , Factores de Tiempo
19.
Hum Mutat ; 43(2): 240-252, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34923728

RESUMEN

Juvenile open-angle glaucoma (JOAG) is a severe type of glaucoma with onset before age 40 and dominant inheritance. Using exome sequencing we identified 3 independent families from the Philippines with novel EFEMP1 variants (c.238A>T, p.Asn80Tyr; c.1480T>C, p.Ter494Glnext*29; and c.1429C>T, p.Arg477Cys) co-segregating with disease. Affected variant carriers (N = 34) exhibited severe disease with average age of onset of 16 years and with 76% developing blindness. To investigate functional effects, we transfected COS7 cells with vectors expressing the three novel EFEMP1 variants and showed that all three variants found in JOAG patients caused significant intracellular protein aggregation and retention compared to wild type and also compared to EFEMP1 variants associated with other ocular phenotypes including an early-onset form of macular degeneration, Malattia Leventinese/Doyne's Honeycomb retinal dystrophy. These results suggest that rare EFEMP1 coding variants can cause JOAG through a mechanism involving protein aggregation and retention, and that the extent of intracellular retention correlates with disease phenotype. This is the first report of EFEMP1 variants causing JOAG, expanding the EFEMP1 disease spectrum. Our results suggest that EFEMP1 mutations appear to be a relatively common cause of JOAG in Filipino families, an ethnically diverse population.


Asunto(s)
Proteínas de la Matriz Extracelular , Glaucoma de Ángulo Abierto , Degeneración Macular , Proteínas de la Matriz Extracelular/genética , Proteínas de la Matriz Extracelular/metabolismo , Glaucoma de Ángulo Abierto/genética , Glaucoma de Ángulo Abierto/metabolismo , Heterocigoto , Humanos , Degeneración Macular/genética , Degeneración Macular/metabolismo , Mutación
20.
Cureus ; 14(12): e33142, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36721591

RESUMEN

Scarlet fever is an infectious illness, which is caused by Streptococcus pyogenes. It causes exanthema and a characteristic tonsillopharyngitis. Its diagnosis is typically straightforward. However, due to the diverse clinical presentation of scarlet fever, one has to be cautious about atypical rash distribution that might go unrecognized or be misdiagnosed. Despite the fact that scarlet fever is primarily a pediatric illness, it can affect people of any age group. The case presented describes the clinical difficulty in the diagnosis of scarlet fever in an adult patient with atypical rash distribution involving dorsum of the hand and feet only till the level of wrists and ankles joints. A high degree of suspicion is required to diagnose this rare presentation and early treatment is essential to limit the spread of the disease.

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