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 who are younger than age 18 years old. It is spread from direct contact with a child who is infected, usually through secretions from the mouth or nose.
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.
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:
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.
Your child's doctor will make the diagnosis based on a complete medical history and physical examination. The rash of scarlet fever is unique and may be 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 will be kept for a throat culture to further identify if there is any GABHS present.
Specific treatment for scarlet fever will be determined by your child's doctor based on:
Your child's age, overall health, and medical history
Extent of the condition
Your child's tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Treatment for scarlet fever is the same as for strep throat. Your child's doctor will 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 (for fever)
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.