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Scarlet fever

Scarlatina

 

Scarlet fever is caused by an infection with bacteria called A streptococcus. This is the same bacteria that cause strep throat.

Causes

 

Scarlet fever was once a very serious childhood disease, but now it is easy to treat. The streptococcal bacteria that cause it produce a toxin that leads to the red rash the illness is named for.

The main risk factor for getting scarlet fever is infection with the bacteria that cause strep throat. An outbreak of strep throat or scarlet fever in the community, neighborhood, or school may increase the risk of infection.

 

Symptoms

 

The time between infection and symptoms is short, most often 1 to 2 days. The illness will likely begin with a fever and sore throat.

The rash first appears on the neck and chest, then spreads over the body. People say it feels like sandpaper. The texture of the rash is more important than the appearance to confirm the diagnosis. The rash can last for more than a week. As the rash fades, the skin around the fingertips, toes, and groin area may peel.

Other symptoms include:

  • Abdominal pain
  • Bright red color in the creases of the underarm and groin
  • Chills
  • Fever
  • General discomfort (malaise)
  • Headache
  • Muscle aches
  • Sore throat
  • Swollen, red tongue (strawberry tongue)
  • Vomiting

 

Exams and Tests

 

Your health care provider may check for scarlet fever by doing a:

  • Physical examination
  • Throat culture that shows bacteria from group A streptococcus
  • Throat swab to do a test called rapid antigen detection

 

Treatment

 

Antibiotics are used to kill the bacteria that cause the throat infection. This is crucial to prevent rheumatic fever, a serious complication of strep throat and scarlet fever.

 

Outlook (Prognosis)

 

With proper antibiotic treatment, the symptoms of scarlet fever should get better quickly. However, the rash can last for up to 2 to 3 weeks before it fully goes away.

 

Possible Complications

 

Complications are rare with the right treatment, but may include:

  • Acute rheumatic fever, which can affect the heart, joints, skin, and brain
  • Ear infection
  • Kidney damage
  • Liver damage
  • Pneumonia
  • Sinus infection
  • Swollen lymph glands or abscess

 

When to Contact a Medical Professional

 

Call your provider if:

  • You develop symptoms of scarlet fever
  • Your symptoms do not go away 24 hours after beginning antibiotic treatment
  • You develop new symptoms

 

Prevention

 

Bacteria are spread by direct contact with infected people, or by droplets an infected person coughs or exhales. Avoid contact with infected people.

 

 

References

Bryant AE, Stevens DL. Streptococcus pyogenes. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 199.

Shulman ST. Group A Streptococcus. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 183.

 
  • Signs of scarlet fever

    Signs of scarlet fever - illustration

    Scarlet fever is a disease caused by an infection with group A beta-hemolytic streptococcal bacteria that occurs in a small percentage of people with strep throat. The illness typically begins with a fever and sore throat. It may be accompanied by chills, vomiting, abdominal pain and malaise. The streptococcal bacteria produces a toxin that causes a rash that appears one to two days after the onset of illness. The rash initially appears on the neck and chest, then spreads over the body. While the rash is still red, the patient may develop Pastia's lines, bright red coloration of the creases under the arm and in the groin.

    Signs of scarlet fever

    illustration

  • Normal lungs and alveoli

    Normal lungs and alveoli - illustration

    The lungs are located in the chest cavity and are responsible for respiration. The alveoli are small sir sacs where oxygen is exchanged in the lungs.

    Normal lungs and alveoli

    illustration

    • Signs of scarlet fever

      Signs of scarlet fever - illustration

      Scarlet fever is a disease caused by an infection with group A beta-hemolytic streptococcal bacteria that occurs in a small percentage of people with strep throat. The illness typically begins with a fever and sore throat. It may be accompanied by chills, vomiting, abdominal pain and malaise. The streptococcal bacteria produces a toxin that causes a rash that appears one to two days after the onset of illness. The rash initially appears on the neck and chest, then spreads over the body. While the rash is still red, the patient may develop Pastia's lines, bright red coloration of the creases under the arm and in the groin.

      Signs of scarlet fever

      illustration

    • Normal lungs and alveoli

      Normal lungs and alveoli - illustration

      The lungs are located in the chest cavity and are responsible for respiration. The alveoli are small sir sacs where oxygen is exchanged in the lungs.

      Normal lungs and alveoli

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Scarlet fever

           

             

            Review Date: 1/10/2016

            Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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