Scarlet Fever
What is scarlet fever?
Scarlet fever is a term used for strep throat with a rash. Scarlet
fever is most common in children ages 2 to 10, but it can affect
people of any age.
What causes scarlet fever?
Scarlet fever is caused by streptococcal (strep) bacteria, the
same bacteria that cause strep throat. There are many different
strains of strep bacteria, some of which cause more serious
illness than others. The type of strep that infects the throat and
causes scarlet fever is called group A beta-hemolytic
streptococcus (GABS).
What are the symptoms?
The symptoms of scarlet fever are the same as the symptoms of strep throat (except for the rash). If you
or your child has the symptoms below, call your doctor. Symptoms include:
 Fever of 101°F (38.33°C) or higher.
 Sore throat and difficulty swallowing.
 White or yellow spots or coating on the throat and tonsils.
 Swollen lymph nodes in the neck.
Other symptoms that appear before the rash, especially in children, may include general body aches,
headache, stomachache, nausea, vomiting, or listlessness. Scarlet fever usually doesn't occur with cold
symptoms, such as sneezing, runny or stuffy nose, or cough.
For more information on strep throat, see the topic Strep Throat.
The most noticeable symptom of scarlet fever is a rough, red rash that feels like fine sandpaper. The rash
usually appears 24 hours after the fever starts. The rash begins on the chest and abdomen and then
spreads over the rest of the body within 1 to 2 days. The rash and redness are more apparent in skin folds,
especially in the groin, armpits, and elbow creases. It usually fades in about a week, and at that time the
skin may begin to peel.
After the skin starts to peel, bright red spots may appear on the tongue, giving it an appearance called
"strawberry tongue."
What Are the Treatments for Scarlet Fever?
Unless treated with antibiotics, scarlet fever can have serious complications. Call your pediatrician
immediately if you think your child has the disease. Along with taking antibiotics, your child should get plenty
of bed rest and drink lots of fluids. Cool baths may reduce the fever, and a humidifier may help relieve the
sore throat.
CAUTION. Never give aspirin to anyone under the age of 20 years who has an infection. It can cause Reye's
syndrome, a rare but possibly deadly disease of the liver.
Your pediatrician will prescribe an antibiotic, such as amoxicillin. If your child is allergic to penicillin, he or she
will be given an alternative, such as azithromycin. The medicine must be taken for its entire course, even if the
symptoms disappear sooner. Kids should not go back to school or day care for 24 hours after starting the
antibiotic. Other family members should also be examined and treated, if necessary. Before the advent of
antibiotics, households were quarantined because of scarlet fever, but this is no longer necessary.
How is scarlet fever diagnosed?
Diagnosis of scarlet fever is usually based on a medical history, an examination of the throat, and a rapid strep
test or throat culture to test for strep bacteria. One or both of these tests are needed to confirm infection with
strep bacteria.
Scarlet fever and the strep infection that causes it are treated with antibiotics.
What are the complications of scarlet fever?
Complications of scarlet fever include infection of the middle ear, sinusitis, and pneumonia. In rare cases, a
more serious infection may develop, such as rheumatic fever or rheumatic heart disease. Most cases of scarlet
fever can be cured without any permanent complications.