Scarlet Fever

Written by Shannon Johnson | Published on August 7, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What is Scarlet Fever?

Scarlet fever is an infection that sometimes occurs after a patient has had strep throat. It is caused by the same family of bacteria that causes strep throat (an infection that makes the throat red, swollen, and sore). Scarlet fever is also known as scarlatina.

Scarlet fever mainly affects children between 5 and 15 years of age. It causes a bright red rash on the body along with a sore throat and fever. The red rash is where the name “scarlet” fever comes from.

Scarlet fever used to be a routine and serious childhood illness, but cases today are relatively rare and antibiotic therapy has reduced the severity of the symptoms and the incidence rates of the disease itself. Researchers do not know why incidents of scarlet fever have decreased while strep throat remains common.

What Are the Symptoms of Scarlet Fever?

Scarlet fever usually follows a strep throat infection. It causes a high fever followed two days later by a rash of small red bumps that looks like a sunburn and feels like sandpaper. The rash begins on the chest and stomach and spreads to the rest of the body. It typically lasts between two and seven days.

After the rash has subsided, the rash site will begin to peel, along with the skin on the tips of the fingers and toes.

Other common symptoms of scarlet fever include:

  • chills
  • headaches
  • a red, sore throat with white and yellow patches
  • swollen tonsils
  • nausea and vomiting
  • swollen glands in the back of the neck
  • a pale area of skin around lips
  • a white tongue with red dots on the surface (strawberry tongue)

How Can a Doctor Tell if I Have Scarlet Fever?

A doctor will swab the back of the throat to collect a sample of your cells for analysis. This is called a throat culture. A rapid strep laboratory test will determine if the strep bacterium is present in your sample cells.

The doctor will also perform a physical exam. During the exam, the doctor will examine the mouth, tongue, throat and tonsils, check for enlarged lymph nodes, and look at the appearance and texture of the rash.

How Is Scarlet Fever Spread?

Group A Streptococcus, the bacterium that causes scarlet fever, lives in the mouth and nasal cavity. If there is an infection with the bacteria, it can be spread by:

  • coughing
  • sneezing
  • touching the mouth, nose, or eyes after touching surfaces or items that might have bacteria on them and then touching another surface without washing your hands
  • sharing cups and utensils with friends and family members

What Is the Treatment for Scarlet Fever?

Doctors usually treat scarlet fever with antibiotics. Antibiotics will help the body’s immune system fight off the bacteria causing the infection. When antibiotics are prescribed, the entire course must be taken to prevent the infection from returning.

Over-the-counter medications like aspirin or ibuprofen can be used to control the fever. In addition, the doctor might prescribe medicine to help ease your sore throat pain. Gargling with salt water and putting a cool air humidifier in the bedroom can also help to minimize the severity and pain of a sore throat.

Eating warm soup, popsicles, or ice cream helps to ease the discomfort of a sore throat. It is important to drink lots of water to avoid dehydration. Children with this infection should avoid school and social activities until antibiotics have been taken and he or she is fever-free for 24 hours.

Complications from Scarlet Fever

In most cases, the rash and other symptoms of scarlet fever will be gone in about two weeks. However, if left untreated, scarlet fever can cause serious complications, including:

  • rheumatic fever
  • kidney disease
  • ear infections
  • skin infections
  • throat abscesses
  • pneumonia
  • arthritis

Most of these complications can be avoided with the prompt prescribing of antibiotic medication.

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