Doctor's Notes on Scarlet Fever
Scarlet fever (also termed scarlatina) is a childhood disease usually occurring in children 2 – 10 years of age (although it can occur in older children and adults) that is characterized by fever, sore throat, and a characteristic rash. The symptoms and signs of scarlet fever begin about four days after exposure to streptococcal infection and may include
- sore throat with a white coating on the tonsils,
- abdominal pain,
- vomiting, and
- swollen lymph nodes on the sides of the neck that may be tender to touch.
The typical rash, consisting of multiple scarlet-red punctate lesions that are small and rough like sandpaper, begins on the chest, neck, and armpits and then spreads to other areas of the body.
- The rash is darker appearing in skin creases; ruptured capillaries in these areas may appear to be lined (termed Pastia lines).
- The face may appear flushed and there may be paleness around the mouth.
- The white coating on the tongue starts in the first one or two days of illness and then it sloughs off revealing a red-colored tongue with prominent papillae (termed strawberry tongue).
- As the patient resolves the infection, the rash fades and the skin begins to peel off; this peeling may last for several weeks.
Scarlet fever is caused by infection with group A beta-hemolytic streptococci bacteria that secretes a toxin responsible for the scarlet-colored rash.
What are the treatments for scarlet fever?
The treatments for scarlet fever usually are antibiotics:
- Oral penicillin
- Oral amoxicillin
- Oral erythromycin (especially for penicillin-allergic individuals
- IM injection of penicillin G (one injection)
Although mild scarlet fever may resolve without antibiotics in about one week, antibiotics speed recovery and reduce the risk of complications.
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