About Scarlet Fever
Scarlet fever is caused by an infection with group A
bacteria. The bacteria make a toxin (poison) that can cause the
scarlet-colored rash from which this illness gets its name.
Not all streptococci bacteria make this toxin and not all kids
are sensitive to it. Two kids in the same family may both have
strep infections, but one child (who is sensitive to the toxin) may
develop the rash of scarlet fever while the other may not. Usually,
if a child has this scarlet rash and other symptoms of
, it can be treated with antibiotics. So if your child has these
symptoms, it's important to call your doctor.
Symptoms of Scarlet Fever
The rash is the most striking sign of scarlet fever. It usually
begins looking like a bad sunburn with tiny bumps and it may itch.
The rash usually appears first on the neck and face, often leaving
a clear unaffected area around the mouth. It spreads to the chest
and back, then to the rest of the body. In body creases, especially
around the underarms and elbows, the rash forms classic red
streaks. Areas of rash usually turn white when you press on them.
By the sixth day of the infection the rash usually fades, but the
affected skin may begin to peel.
Aside from the rash, there are usually other symptoms that help
to confirm a diagnosis of scarlet fever, including a reddened sore
above 101Âº Fahrenheit (38.3Âº Celsius), and swollen glands in the
neck. The tonsils and back of the throat may be covered with a
whitish coating, or appear red, swollen, and dotted with whitish or
yellowish specks of pus. Early in the infection, the tongue may
have a whitish or yellowish coating. A child with scarlet fever
also may have chills, body aches, nausea, vomiting, and loss of
When scarlet fever occurs because of a throat infection, the
fever typically stops within 3 to 5 days, and the sore throat
passes soon afterward. The scarlet fever rash usually fades on the
sixth day after sore throat symptoms began, but skin that was
covered by rash may begin to peel. This peeling may last 10 days.
With antibiotic treatment, the infection itself is usually cured
with a 10-day course of antibiotics, but it may take a few weeks
for tonsils and swollen glands to return to normal.
In rare cases, scarlet fever may develop from a streptococcal
skin infection like
. In these cases, the child may not get a sore throat.
Preventing Scarlet Fever
The bacterial infection that causes scarlet fever is contagious.
A child who has scarlet fever can spread the bacteria to others
through nasal and throat fluids by sneezing and coughing. If a
child has a skin infection caused by strep bacteria, like impetigo,
it can be passed through contact with the skin.
In everyday life, there is no perfect way to avoid the
infections that cause scarlet fever. When a child is sick at home,
it's always safest to keep that child's drinking glasses
and eating utensils separate from those of other family members,
and to wash these items thoroughly in hot soapy water. Wash your
own hands frequently as you care for a child with a strep
Treating Scarlet Fever
If your child has a rash and the doctor suspects scarlet fever,
he or she will usually take a throat culture (a painless swab of
throat secretions) to see if the bacteria grow in the laboratory.
Once a strep infection is confirmed, the doctor will likely
prescribe an antibiotic for your child to be taken for about 10
Caring for a Child With Scarlet Fever
A child with severe strep throat may find that eating is
painful, so providing soft foods or a liquid diet may be necessary.
Include soothing teas and warm nutritious soups, or cool soft
drinks, milkshakes, and ice cream. Make sure that the child drinks
plenty of fluids.
Use a cool-mist humidifier to add moisture to the air, since
this will help soothe the sore throat. A moist warm towel may help
to soothe swollen glands around your child's neck.
If the rash itches, make sure that your child's fingernails
are trimmed short so skin isn't damaged through
When to Call the Doctor
Call the doctor whenever your child suddenly develops a rash,
especially if it is accompanied by a fever, sore throat, or
swollen glands. This is especially important if your child has any
of the symptoms of strep throat, or if someone in your family or in
your child's school has recently had a strep infection.
Joel Klein, MD
Date reviewed: April 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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