Scarlet
Fever
DEFINITION:
A fever, rash and associated symptoms due to a strept infection.
SYMPTOMS:
Fever, throat pain, malaise, and a red rash on the body.
CAUSES:
A
toxin released by Group A beta hemolytic Streptococcus.
DIAGNOSIS:
This illness is diagnosed by the symptoms of the child plus
a strept test showing strept
throat.
TREATMENT:
Antibiotics
such as penicillin or amoxicillin.
OUTCOME:
Excellent with treatment. If left untreated it can progress
to rheumatic fever or kidney disease.
CONTAGION:
Strept
throat is contagious when one is exposed to the respiratory
droplets of an infected person. Strept throat may or may not
turn into scarlet fever. A person with strept throat is contagious
until he or she has been placed on an appropriate antibiotic
for 24 hours. The incubation period is 2 to 3 days.
DISCUSSION:
A
toxin released by the streptococcus bacterium causes scarlet
fever. This illness can present with fevers of up to 104 degrees,
chills, sore throat, and a characteristic rash. Usually, the
throat is red and inflamed; the tongue is usually white at
first (white strawberry tongue), then turns very red and looks
like a strawberry (red strawberry tongue). The rash feels
like sandpaper when you rub the skin. A throat culture or
rapid strept test is done to determine whether a person has
strept throat. Scarlet fever can also occur after strept infections
of the skin, such as impetigo.
Once a diagnosis is made, treatment with penicillin or amoxicillin
will quickly alleviate the symptoms. In patients allergic
to these drugs, other antibiotics can be used. With treatment,
the outcome is excellent.
ONE DOCTOR'S OPINION:
This
rash looks like so many other rashes in children. However,
only this rash feels like sandpaper when you touch it. Any
time a child comes in with a rash and sore throat I run a
strept test to check for scarlet fever or scarlitiniform rash.
Once a diagnosis is made, treatment is easy and symptoms resolve
quickly. If a child has a history of strept throat or impetigo,
this rash can develop, but the strept test may be negative.
This makes definitive diagnosis more difficult. However, there
are other lab tests that tell if there has been a previous
strept infection. They are called antistreptolysin O (ASO
titer), or antiDNase B (ADB titer). If either of these blood
tests are positive, then treatment can be started.
