Scarlet Fever/Scarlatina

Scarlet Fever/Scarlatina

 

Key Points
Bacterial infection which typically affects children
Caused by a bacterial infection by certain group A streptococcus bacteria
Cutaneous symptoms consist of a rash of very small, reddish-pink spots over the entire body

Scarlet fever is a bacterial infection which typically affects children. The condition is typically preceded by a sore throat or Impetigo, and initially consists of fever, sore throat, swollen glands, headache, vomiting and nausea, swelling and redness of the tongue, abdominal pain and a general feeling of unwellness. Cutaneous symptoms usually appear within 1 to 2 days of the onset of the condition, and consist of a rash of very small, reddish pink spots over the entire body, though it usually begins on the torso, armpits, neck, groin or below the ears. This may be preceded by the appearance of red blotches on the skin. As the rash develops, it resembles a sunburn covered in tiny bumps, and may have a rough texture. In areas with skin folds, capillaries may burst and cause red streaking, known as Pastia lines, which may persist after the rash resolves. Resolving rashes will typically fade and peel, which may continue for up to 6 weeks. Untreated, fever peaks and resolves within a week. However, complications such as rheumatic fever, otitis media, pneumonia, septicaemia, glomerulonephritis, osteomyelitis, and death can occur if scarlet fever is not promptly treated.

Scarlet fever is caused by an infection of certain bacteria within group A streptococcus, which is easily transmitted via skin-to-skin contact or from inhalation of airborne matter from an infected person. Additionally, some persons may be carriers of the bacteria. Persons in areas with dense populations, children over the age of 3, and those in contact with persons who have a throat or skin infection are at increased risk for acquiring the condition.

Differential Diagnosis (Other conditions with similar appearance)
Drug eruptions
Lupus erythematosus, Acute
Measles, Rubeola
Rubella
Toxic shock syndrome

Diagnosis
Key Points
Diagnosis based on the characteristic appearance of the affected area in conjunction with clinical examination
Laboratory testing will be performed to confirm diagnosis and to rule out similar appearing conditions

Scarlet fever is typically diagnosed based on the characteristic appearance of the affected area in conjunction with clinical examination. Laboratory testing will be performed to confirm the diagnosis and to rule out similar appearing conditions.

Treatment
Treatment typically consists of a course of Antibiotics
Various other self-care options are available to relieve symptoms
With proper treatment, major symptoms resolve within 5 days

Scarlet fever is typically treated with a short course of Antibiotics, typically under 10 days. Health care professionals may, in some cases, opt for a single intravenous dose of antibiotics, typically penicillin or erythromycin. Additionally, various self-care measures should be utilized to relieve symptoms, including acetaminophen for fever and pain, oral antihistamines or lotions to relieve itching, and eating soft foods and taking in cool liquids to manage throat pain.