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Scarlet Fever Rash

Although scarlet fever (scarlatina) usually follows streptococcal pharyngitis, this disorder also may follow other streptococcal infections, such as wound infections, urosepsis, and puerperal sepsis. It's most common in children ages 3 to 15. The incubation period commonly lasts from 2 to 4 days but may be only 1 day or extend to 7 days.

To get scarlet fever you must still be susceptible to the toxin produced by the streptococcal bacteria. Therefore, it can happen that 2 children of the same family may both have streptococcal infections, but only one (who is still susceptible to the toxin) develops scarlet fever.

Scarlet fever generally has a 1- to 4-day incubation period.


Group A beta-hemolytic streptococci cause scarlet fever. The infecting strain produces one of three erythrogenic toxins, which triggers a sensitivity reaction in the patient.


The following are the most common initial (before the rash develops) symptoms of scarlet fever. However, each child may experience symptoms differently. Symptoms may include:

  • fever
  • sore throat
  • chills
  • headache
  • vomiting
  • stomach ache
  • coated white tongue

The rash begins approximately one to two days after the initial infection. The red, fine, sandpaper-like rash typically is noted on the neck, forehead, cheeks, and chest and then may spread to the arms and back. The rash usually begins to fade after three to four days.

The symptoms of scarlet fever may resemble other skin conditions or medical problems. Always consult your child's physician for a diagnosis.

Diagnostic tests

Diagnosis of scarlet fever is often suspected from the characteristic history and physical examination. Taking a throat swab sample and testing it for bacterial growth is often done.


Antibiotic therapy with penicillin or erythromycin is administered for 10 days, along with antipyretics.


Bacteria are spread by direct contact with infected persons or by droplets exhaled by an infected person. Avoid contact with infected persons.

In everyday life, there is no perfect way to avoid the infections that cause scarlet fever. When a child is sick at home, it's always safest to keep that child's drinking glasses and eating utensils separate from those of other family members, and to wash these items thoroughly in hot soapy water. Wash your own hands frequently as you care for a child with a strep infection.

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