Scarlet Fever
What is scarlet fever?
Scarlet fever is a strep throat infection with a rash. Your child
will have a sore throat and fever before the rash (usually 18 to
24 hours before). Once your child gets the rash, it will spread
all over the body within 24 hours.
Your child will have:
- Reddened, sunburned-looking skin (especially on the chest and
abdomen) that feels rough, somewhat like sandpaper. On close
inspection, the redness is speckled (tiny pink dots).
- Increased redness in skin folds (especially the groin,
armpits, and elbow creases).
- Flushed face with paleness around the mouth.
- A sore throat and fever.
- Swollen glands in the neck (in some cases).
What is the cause?
Scarlet fever is caused by the strep bacteria. The rash is caused
by a toxin that is produced by some strep bacteria. The
complication rate is no different than the complication rate for
strep throat alone.
How long does it last?
The red rash usually clears in 4 or 5 days. Sometimes the skin
peels in 1 to 2 weeks where the rash was most prominent (for
example, the groin). The skin on the fingertips also commonly
peels. Your child will stop having a sore throat and fever after
taking an antibiotic for 1 or 2 days.
How can I take care of my child?
- Antibiotics
Your child's antibiotic is ____________________________. Your
child's dose is ____________, given ___ times a day during
waking hours for 10 days.
Try not to forget any of the doses. Give the medicine until
all the pills are gone or the bottle is empty. Even though
your child will feel better in a few days, give the antibiotic
for 10 days to keep the strep throat from flaring up again.
If the medicine is a liquid, store it in the refrigerator. Use
a measuring spoon to be sure that you give the right amount.
A long-acting penicillin (Bicillin) injection can be given if
your child will not take oral medicines or if it will be
impossible for you to give the medicine regularly. (Note: If
given correctly, the oral antibiotic works just as rapidly and
effectively as a shot.)
- Relief of sore throat or fever
Acetaminophen or ibuprofen is very helpful for throat pain.
Children over 1 year old can sip warm chicken broth or apple
juice. Children over 4 years old can suck on hard candy or
lollipops. Also give acetaminophen (Tylenol) or ibuprofen
(Advil) for fevers over 102°F (39°F). A humidifier helps to
keep the air in your child's room moist. This will keep the
throat from getting dry and more painful.
- The rash
The rash itself needs no treatment. It generally clears in 4
to 5 days.
- Contagiousness
Your child is no longer contagious after he or she has been on
an antibiotic for 24 hours. Therefore, your child can return
to school after 1 day if he or she is feeling better. The rash
itself is not contagious.
- Throat cultures for the family
Scarlet fever and strep throat can spread to others in the
family. Any child or adult who lives in your home and has a
fever, sore throat, runny nose, headache, vomiting, or sores;
or who doesn't want to eat; or who develops these symptoms in
the next 5 days should have a throat culture. Usually, your
healthcare provider needs to culture only those who are sick.
(EXCEPTION: In families where relatives have had rheumatic
fever or frequent strep infections, everyone should come in
for a throat culture.) Your healthcare provider will call you
if any of the cultures are positive for strep.
- Recurrent strep throat and repeat cultures
Usually repeat throat cultures are not necessary if your child
takes all of the antibiotic. However, if your child continues
to have a sore throat or mild fever after treatment is
completed, return for a second throat culture. If it is
positive, your child will be given a different antibiotic.
When should I call my child's healthcare provider?
Call IMMEDIATELY if:
- Your child starts acting very sick.
Call during office hours if:
- The fever lasts over 48 hours after your child starts taking
the antibiotic.
- Your child continues to have a sore throat after antibiotic
treatment is completed.
- You have other concerns or questions.
Written by B.D. Schmitt, MD, author of "Your Child's Health," Bantam Books.
Published by
RelayHealth.
Last modified: 2007-04-19
Last reviewed: 2008-06-09
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
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