Carl R. Darnall Army Medical Center - Health Library

Scarlet Fever



Scarlet fever is an infection which produces a sore throat, fever, and a specific rash.

Sore Throat Due to Inflammation

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Causes ^

Scarlet fever is caused by specific bacteria. The bacteria produces a toxin that causes a rash. Scarlet fever usually develops in conjunction with strep throat.

Risk Factors ^

Factors that may increase the chances of scarlet fever:

  • Untreated strep infection
  • Close contact with someone who has an untreated strep infection
  • Overcrowded conditions, such as a school or daycare

Symptoms ^

Symptoms may include:

  • High fever
  • Specific, spreading rash that feels like sand paper
  • Flushing in the face with paleness around the mouth
  • Red streaks, called Pastia lines, on elbows, underarms, and body creases
  • Swollen glands in the neck
  • Chills
  • Pain in the abdomen
  • Bright red tongue
  • Body aches
  • Headache
  • Vomiting

In rare cases, untreated strep throat infection may cause:

  • Rheumatic fever
  • Kidney damage
  • Spread of the infection to other areas such as the ears, sinuses, or lungs
  • Streptococcal toxic shock syndrome
  • Local abscess

Diagnosis ^

You will be asked about your symptoms and medical history. A physical exam will be done. The doctor may diagnose scarlet fever by the specific rash. Confirmation of scarlet fever can be done with a throat swab or rapid strep antigen detection test.

Treatment ^

The infection that causes scarlet fever can be treated with antibiotics. It is important to take all the prescribed medication. Doing so will prevent scarlet fever from returning, and also prevent complications.

There is no specific treatment for the rash. After the rash fades, the skin peels for several weeks.

Prevention ^

To help reduce the chances of scarlet fever:

  • Avoid contact with people who have untreated strep infections.
  • Wash your hands frequently.
  • Have other household members or contacts tested for strep infection.

Family Doctor—American Academy of Family Physicians

Kids Health—Nemours Foundation


About Kids Health—The Hospital for Sick Children

Caring for Kids—Canadian Paediatric Society


Group A Streptococcus. EBSCO DynaMed website. Available at: Updated February 8, 2018. Accessed February 15, 2018.

McKinnon HD Jr, Howard T. Evaluating the febrile patient with a rash. Am Fam Physician. 2000;62(4):804-816.

Streptococcal infections. Merck Manual Professional Version website. Available at: Updated September 2017. Accessed February 15, 2018.

Streptococcus. PEMSoft at EBSCO DynaMed Plus website. Available at: Accessed February 15, 2018.

Last reviewed February 2018 by EBSCO Medical Review Board David L. Horn, MD, FACP  Last Updated: 1/13/2014