Children's Health and Wellness

Scarlet Fever

What is scarlet fever?

Scarlet fever, also known as scarlatina, is an infectious disease that causes a rash. It is associated with an infection by streptococci, the same kind of bacteria that causes strep throat. It may also be associated with wounds or burns that become infected. The rash of scarlet fever is typically a fine, "sandpaper-like" rash that consists of small, red bumps.

Scarlet fever most commonly occurs in children between 5 and 12 years old.  It is spread from direct contact with a person who is infected, usually through secretions from the mouth or nose.

What causes scarlet fever?

Scarlet fever is caused by toxins that are produced by bacteria called group A beta-hemolytic streptococcus (GABHS). These bacteria release a toxin that travels through your child's bloodstream and causes a rash.

What are the symptoms of scarlet fever?

The following are the most common initial (before the rash develops) symptoms of scarlet fever. However, each child may experience symptoms differently. Symptoms may include:

  • Fever

  • Sore throat

  • Chills

  • Headache

  • Vomiting

  • Stomachache

  • Coated white tongue

  • Strawberry-like appearance of the tongue

The rash begins approximately one to two days after the initial infection. The red, fine, sandpaper-like rash typically is noted on the neck, forehead, cheeks, and chest and then may spread to the arms and back. The rash usually begins to fade after two to seven days.

The symptoms of scarlet fever may resemble other skin conditions or medical problems. Always consult your child's doctor for a diagnosis.

How is scarlet fever diagnosed?

Your child's doctor will make the diagnosis based on a complete medical history and physical exam. The rash of scarlet fever is unique and may be easily recognized by your child's doctor. In addition, your child's doctor may order a throat swab to confirm the diagnosis of strep throat as the source of the scarlet fever. A quick test, called a rapid strep test, may be performed. This may immediately test positive for GABHS. However, if it is negative, part of the throat swab may be sent for a throat culture to further identify if there is any GABHS present.

What is the treatment for scarlet fever?

 

Treatment for scarlet fever is the same as for strep throat. Your child's doctor will often prescribe an appropriate antibiotic to treat the infection. Untreated strep throat or scarlet fever can lead to several serious conditions involving the heart, kidneys, and liver. When the heart is involved, it is called rheumatic fever, so it is very important to finish the full course of antibiotics. Other treatment options may include:

  • Warm saline mouth gargles (to relieve the sore throat)

  • Acetaminophen or ibuprofen (for fever or throat pain). Never give aspirin to a child, it can cause a dangerous condition called Reye Syndrome.

  • Increased fluid intake

It is important to not send your child back to school or day care until he or she has been on antibiotics for at least 24 hours. Also, be sure to notify others who may have been exposed.

Online Source: Centers for Disease Control and Prevention. Scarlet Fever: A Group A Streptoccal Infectionhttp://www.cdc.gov/features/scarletfever/
Online Source: American Academy of Pediatrics. Scarlet Feverhttp://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Scarlet-Fever.aspx
Online Source: National Institute of Allergies and Infectious Diseases. Scarlet Feverhttp://www.niaid.nih.gov/topics/scarletfever/Pages/Default.aspx
Online Editor: Metzger, Geri
Online Medical Reviewer: Hanrahan, John, MD
Online Medical Reviewer: newMentor board-certified, academically affiliated clinician
Date Last Reviewed: 6/24/2013
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