Scarlet Fever

Scarlet Fever Summary
Scarlet fever is an infectious disease caused by the bacteria group A Streptococcus. Symptoms and signs include a rash, sore throat, and fever. Antibiotics are used in the treatment of scarlet fever.
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Scarlet fever facts

  • Scarlet fever is caused by bacteria known as group A streptococci (GAS).
  • The infection usually starts with a sore throat and fever, followed within 48 hours by a rash. Less commonly, the infection starts as a wound infection.
  • The rash starts on the trunk and spreads to the arms and legs. It looks like sunburn, but it feels rough like sandpaper. The rash may be redder in skin folds. As the rash starts to go away, the skin may peel.
  • Tongue changes are common during the disease ("strawberry tongue"). The tongue may first appear white with red bumps and then turn beefy red.
  • Scarlet fever is diagnosed by examination of the rash and swabbing the throat to look for GAS. Blood tests may be done in some cases.
  • The disease is treated with rest, fluids, and antibiotics.
  • Scarlet fever responds well to treatment and the disease resolves completely in most people. Complications are rare but may occur when the disease goes untreated or bacteria spread to the bloodstream, bone, or tissues.
  • People with scarlet fever should cover their coughs, wash hands frequently, and not share utensils. They should not go to school or work until they have been on antibiotics for at least 24 hours.

What is scarlet fever?

Scarlet fever is an infectious disease caused by bacteria known as group A. Streptococcus (GAS). GAS causes many other infections, but the strain of GAS bacteria that causes scarlet fever is different because it produces a toxin. The toxin causes the characteristic red skin rash for which scarlet fever is known. Scarlet fever is more common in children (ages 4-8) than adults. The infection often starts in the throat and has the symptoms of a typical strep throat but goes on to produce the skin rash. Scarlet fever is usually mild and resolves with antibiotic treatment. However, a small proportion of people experience very severe disease that may include bacterial invasion into the bloodstream (sepsis), tissues, or bone. Severe disease was more common before the discovery of antibiotics.

Medically Reviewed by a Doctor on 12/20/2013

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Scarlet Fever Symptoms and Signs

Sore Throat: Virus or Strep?

Medical Author: Melissa Conrad Stöppler, M.D.
Medical Editor: William C. Shiel, Jr, MD, FACP, FACR

Are you wondering if your sore throat requires antibiotics? Strep throat, named for the Streptococcus bacterium that causes the condition, is a particularly severe form of sore throat that is best treated with antibiotics. Strep throat can strike both children and adults, but only about five to ten percent of sore throats are caused by a bacterial infection. Most sore throats are caused by viral illnesses and are not responsive to treatment with antibiotics.

A true streptococcal infection of the throat often leads to excruciating throat pain accompanied by difficulty swallowing and even speaking. Fevermay be present, and the tonsilsare often covered with a whitish layer of pus. Coughand runny noseare not commonly related to strep throat, but it is possible to have a streptococcal infection along with a viral upper respiratory infectionand symptoms of a cold. The bacterial infection may result in enlarged, tender lymph nodes in the neck. Children may have an accompanying rash; a streptococcus infection along with a rash is commonly termed scarlet fever.


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