Scarlet fever is a disease caused by infection with the group A Streptococcus bacteria (the same bacteria that cause strep throat).

Causes, incidence, and risk factors
Scarlet fever was once a very serious childhood disease, but now is easily treatable with antibiotics. It is caused by the streptococcal bacteria, which produce a toxin that leads to the hallmark red rash of the illness. The main risk factor is infection with the bacteria that causes strep throat. A history of strep throat or scarlet fever in the community, neighborhood, or school may increase the risk of infection.


strep1The time between becoming infected and having symptoms is short, generally 1 – 2 days. The illness typically begins with a fever and sore throat.

The rash usually first appears on the neck and chest, and then spreads over the body. It is described as “sandpapery” in feel. The texture of the rash is more important than the appearance in confirming the diagnosis. The rash can last for more than a week. As the rash fades, peeling (desquamation) may occur around the fingertips, toes, and groin area.

Other symptoms include:

  1. Abdominal pain
  2. Bright red color in the creases of the underarm and groin (Pastia’s lines)
  3. Chills
  4. Fever
  5. General discomfort (malaise)
  6. Headache
  7. Muscle aches
  8. Sore throat
  9. Swollen, red tongue (strawberry tongue)
  10. Vomiting

strep2Signs and tests

  • Physical examination
  • Throat culture positive for group A strep
  • Rapid antigen detection (throat swab)


  • Antibiotics are used to kill the bacteria that cause the throat infection.
  • For sore throat pain, you may use a combination of equal parts of over the counter medications (Benadryl Allergy 12.5mg/5ml and cherry Maalox.)

Dosage for children over 24lbs, use 1tsp or 5ml of benadryl and 5ml of cherry Maalox. For children less than 24lbs or larger children consult Dr. Eisner on dosage or you may use same dose as given on fever sheet for Tylenol elixir.

strep3Expectations (prognosis)

With proper antibiotic treatment, the symptoms of scarlet fever should get better quickly. However, the rash can last for up to 2 – 3 weeks before it fully goes away.


  • It is crucial to treat strep throat / scarlet fever, because if left untreated it could
  • lead to Acute rheumatic fever or Kidney damage (glomerulonephritis)