Definition

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.
RESOURCES:

Family Doctor—American Academy of Family Physicians
https://familydoctor.org

Kids Health—Nemours Foundation
http://kidshealth.org

CANADIAN RESOURCES:

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca

Caring for Kids—Canadian Paediatric Society
https://www.caringforkids.cps.ca

REFERENCES:

Group A Streptococcus. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T903304/Group-A-Streptococcus. Accessed January 29, 2021.

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

Streptococcus. PEMSoft at EBSCO DynaMed website. Available at: http://pemsoft.ebscohost.com/content/PPacCore/UID188658.html. Accessed January 29, 2021.

Last reviewed March 2020 by EBSCO Medical Review Board David L. Horn, MD, FACP  Last Updated: 1/29/2021