Overview
Scarlet fever is a bacterial illness caused by group A streptococcus bacteria, the same type responsible for strep throat. It is characterized by a bright red rash covering most of the body, usually accompanied by a sore throat and high fever. The rash appears like a sunburn and feels like sandpaper. The infection is contagious and can spread through droplets from an infected person's cough or sneeze. Scarlet fever is most common in children between 5 and 15 years of age. If left untreated, it can lead to more severe complications affecting the heart, kidneys, and other body parts. Antibiotic treatments have made it less threatening, but early diagnosis and treatment are crucial to prevent potential complications.
Understanding the disease
Symptoms
The symptoms of scarlet fever include:
- Red rash that feels like sandpaper and typically begins on the face or neck, spreading to the trunk, arms, and legs. Pushing on the reddened skin makes it turn pale.
- Red lines in the folds of skin around the groin, armpits, elbows, knees, and neck, which become deeper red than other rash areas.
- A flushed face with a pale ring around the mouth.
- A red and bumpy tongue covered with a white coating early in the disease.
- A sore and red throat, sometimes with white or yellowish patches.
- Difficulty swallowing.
- Enlarged glands in the neck that are tender to the touch.
- Nausea or vomiting.
- Abdominal pain.
- Headache and body aches. Scarlet fever is usually accompanied by a fever of 100.4 F (38.0 C) or higher, often with chills, and can lead to more severe conditions if left untreated.
Risk Factors
The risk factors for developing scarlet fever include:
- Age: Children 5 to 15 years old are more likely to get scarlet fever than other age groups.
- Close contact: Scarlet fever germs spread more easily among people in close contact, such as family members, child-care groups, or classmates.
- Previous infections: Scarlet fever often occurs after a strep throat infection, and sometimes after a skin infection like impetigo.
- Poor sanitation and overcrowding: These conditions can increase the risk of spreading the bacteria that cause scarlet fever. Remember that scarlet fever is caused by the group A streptococcus bacteria, and the bacteria release a toxin that produces the rash and red tongue. The infection spreads from person to person through droplets released when an infected person coughs or sneezes.
Development
Scarlet fever is caused by the group A streptococcus bacteria, which also cause strep throat. The bacteria release a toxin that leads to the characteristic symptoms of scarlet fever, including a bright red rash, sore throat, and high fever. The infection spreads from person to person through droplets released during coughing or sneezing. Scarlet fever can occur after a strep throat infection, or sometimes after a skin infection like impetigo. It's more common among children aged 5 to 15 years and can spread more easily among people in close contact, such as family members, child-care group members, or classmates. If left untreated, scarlet fever can lead to more severe complications affecting the heart, kidneys, and other parts of the body. Rarely, it can also lead to rheumatic fever, which can affect the heart, joints, nervous system, and skin.
Assessment and Diagnosis
Triage
You should see a doctor if scarlet fever is suspected when you have a rash that's swollen, tender, and warm, and it's expanding but you don't have a fever. Additionally, seek emergency care if you have a swollen, tender rash or a rash that's changing rapidly, or if you have a fever. It's essential to identify and treat scarlet fever early to prevent potential complications that can affect the heart, kidneys, and other parts of the body.
Diagnosis
To diagnose scarlet fever, a healthcare provider will conduct a physical exam, assessing the appearance and texture of the rash, examining the condition of the child's throat, tonsils, and tongue, and feeling the child's neck for enlarged lymph nodes. If suspected, a throat swab may be performed to collect material that may contain the strep bacteria. A rapid strep test can provide quick results, while a strep throat culture may take longer. Proper diagnosis is important as scarlet fever requires specific treatment with antibiotics.
Management and Treatment
Complications
Complications of scarlet fever can include issues with the tonsils, skin, blood, middle ear, sinuses, lungs, heart, kidneys, and joints. If left untreated, the bacteria can spread to these areas and lead to serious conditions. In rare cases, scarlet fever can also lead to rheumatic fever, an inflammatory disease affecting the heart, joints, nervous system, and skin. There is also a suggested but controversial relationship between strep infection and pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS), which can cause worsened symptoms of neuropsychiatric conditions in some children.
Prevention
Scarlet fever can be prevented by following standard precautions against infections. The best ways to prevent scarlet fever include washing your hands thoroughly with warm soapy water for at least 20 seconds or using alcohol-based hand sanitizer if soap and water are not available. Additionally, prompt and complete treatment of strep throat infections or scarlet fever with a full course of appropriate antibiotics can help prevent the development of rheumatic fever, although it does not directly prevent scarlet fever itself.
Treatment
Treatment for scarlet fever primarily involves antibiotics to combat the bacterial infection caused by group A streptococcus. The most common antibiotics used to treat scarlet fever are penicillin and amoxicillin, prescribed by a healthcare professional. The antibiotics help to reduce the duration and severity of symptoms, as well as prevent potential complications. In addition to antibiotics, the following self-care measures can help alleviate symptoms:
- Drinking plenty of fluids to stay hydrated
- Taking over-the-counter pain relievers, such as acetaminophen or ibuprofen, to help reduce fever and discomfort
- Using a humidifier or taking a steamy shower to help alleviate sore throat It's essential to follow the full course of antibiotics prescribed by a healthcare provider to ensure the infection is completely treated and reduce the risk of recurrence or antibiotic resistance. Remember, if you suspect scarlet fever, consult a healthcare professional for proper diagnosis and treatment.
Preparing for medical consultation
To prepare for an appointment for scarlet fever, you can:
- Make a list of questions to ask your health care provider, such as when your child will start feeling better, the risk of long-term complications, how to soothe skin, when your child can return to school, whether your child is contagious, and alternative medication options if your child is allergic to penicillin.
- Note any symptoms experienced and their duration.
- Gather information about your child's recent exposure to possible sources of infection and any international travel history, including dates and countries visited.
- Bring a record of your child's immunizations, including pre-travel vaccinations.
- Create a list of your child's key medical information, including any other conditions being treated and all medications, vitamins, or supplements currently taken. Remember to follow any pre-appointment restrictions and ask about office visit instructions to avoid spreading the infection. Be prepared to share this information with your health care provider during the appointment.