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 .
Symptoms typically appear three days after exposure to another person with the illness, although the incubation period can be anywhere from one to seven days.
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:
· Bright red or scarlet spotty rash, usually beginning on the neck or chest (often excludes face, palms, and soles of the feet)
· High fever (38.33°C) or higher.
· Sore throat (although half of patients will not have this symptom)
· Painful swallowing
· Tongue with white coating and red bumps -- referred to as strawberry tongue
· Swollen glands in neck (Swollen lymph nodes in the neck).
· White or yellow spots or coating on the throat and tonsils.
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.
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. As the rash fades, there may be skin peeling around the tips of the fingers and toes and in the groin area.
After the skin starts to peel, bright red spots may appear on the tongue, giving it an appearance called "strawberry tongue."
The tongue also becomes swollen and turns bright red. After two to seven days the rash usually disappears, but the tongue may remain swollen for several more days.
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. 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.
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 cephlexin. 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.
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.
How Can I Prevent Scarlet Fever?
To prevent scarlet fever, avoid people who have a strep infection. Wash your hands often and avoid sharing eating utensils or drinks
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