Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
The symptoms and signs of scarlet fever usually begin one to four days after exposure
to the streptococcal infection (incubation period). As previously mentioned,
scarlet fever typically occurs in association with a pharyngeal streptococcal
infection, therefore many of the symptoms and signs initially will be similar to
that of strep throat and may include any of the following:
The throat may appear reddened and swollen, and there may be white patches
on the tonsils or on the back of the throat (tonsillar exudate).
Swollen and tender lymph nodes on the sides of the neck (cervical
Approximately one to four days after the onset of illness, a characteristic skin rash
will appear with the following properties.
The rash typically begins on the chest, neck, and armpit area and then
spreads to other areas of the body.
The rash is often more pronounced and reddened in areas of skin creases,
such as the axilla, the neck, the inguinal area, and in the creases of the elbow
(antecubital fossa) and the knee (popliteal fossa). Ruptured capillaries in
these areas may cause the resultant rash to appear as lines (termed Pastia
The rash is described as fine and rough-textured (like sandpaper),
consisting of multiple red punctate lesions. The rash blanches when pressed
The face may appear flushed, and the area around the mouth may appear pale
The rash may last anywhere between two to seven days. After the rash has faded, the
skin begins to peel (desquamation), and this may last up to several weeks. The
extent and duration of skin peeling is directly related to the initial severity
of the rash. Areas commonly affected include the fingers, toes, palms, axilla,
and the groin.
During the first one to two days of illness, the tongue may have a white-colored
coating with protruding, swollen, and red papillae on the surface. After about
four to five days, the white coating sloughs off revealing a red-colored tongue with
prominent papillae (strawberry tongue).
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