Scarlet fever is a bacterial illness that may develop in people who have strep throat (or more rarely from impetigo). Some types of bacteria that cause strep throat (group A Streptococcus) release a toxin that causes a red rash. Not everyone is sensitive to the toxin; therefore, in the same family one child may just have strep throat, while the other may have strep throat with the rash. Children 5-15 years of age are more likely than other ages to develop scarlet fever. The bacteria causing scarlet fever spreads through person-to-person via air droplets when an infected person sneezes or coughs.
In addition to the symptoms due to a strep throat, symptoms of scarlet fever include a red rash that has the appearance of sunburn and feels like sandpaper. The rash begins on the face or neck and will spread to the rest of the body. The folds of skin may become a deeper red than the rest of the rash and the face may appear flushed with a pale ring around the mouth. Other symptoms may include fever, sore and red throat with white or yellow patches, difficulty swallowing, nausea, vomiting, body aches, abdominal pain, headache and enlarged glands in the neck (lymph nodes) that are tender to touch.
Diagnosis will involve a physical examination of the neck, throat, tonsils, and tongue as well as assessing the appearance and texture of the rash if present. A doctor will confirm the presence of strep bacteria by a throat swab. Treatment will involve antibiotics and supportive therapy including fluids, treating fever and pain, or humidifying the air. It is important for a child to be treated if they develop scarlet fever because rare complications such as rheumatic fever, rheumatic heart disease, and kidney problems may develop. Prognosis with treatment is excellent. If you or your child develops a rash with a sore throat, talk with your doctor about the most current treatment options.