What is scarlet fever?

Scarlet fever is an infection that can happen with strep throat. It is caused by the same bacteria that cause strep throat.

Scarlet fever and strep infections are treated with antibiotics. Treatment can prevent serious problems from a strep infection. The strep infection that causes scarlet fever can be spread to others until you no longer have a fever and until you have taken antibiotics for at least 12 hours.

The rough, red rash that occurs with scarlet fever usually fades in about a week. After the rash fades, the skin may begin to peel.

Scarlet fever causes a rough, red rash along with symptoms of strep throat. These may include:

• A fever.
• A sore throat and pain when swallowing.
• A red, swollen throat or tonsils.
• White spots or coating on the throat and tonsils.
• Bright red spots on the tongue ("strawberry tongue").
• Swollen lymph nodes in the neck.

The rash usually appears one or two days after the fever starts. The rash starts on the neck, underarm, and groin area and then spreads to the rest of the body. The rash usually fades in about a week. Then the skin may start to peel.

Other symptoms that may appear before the rash include general body aches, headache, stomachache, nausea, vomiting, or listlessness. These symptoms are more common in children than in adults.

Scarlet fever is treated with antibiotics. Treatment can prevent serious problems. If it's not treated, scarlet fever can lead to problems such as middle ear infection, sinusitis, and pneumonia. In rare cases, it can lead to rheumatic fever.

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.

• Take your antibiotics exactly as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Until you no longer have a fever and until you have taken antibiotics for at least 12 hours, avoid contact with other people, especially infants and children. Do not go to work or school. Keep your drinking glass and eating utensils separate, and wash these items well in hot, soapy water.
• Gargle with warm salt water once an hour to help reduce swelling and relieve pain. Use 1 teaspoon of salt mixed in 8 fluid ounces of warm water.
• Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
• Be careful when taking over-the-counter cold or flu medicines and Tylenol at the same time. Many of these medicines have acetaminophen, which is Tylenol. Read the labels to make sure that you are not taking more than the recommended dose. Too much acetaminophen (Tylenol) can be harmful.
• Try an over-the-counter anesthetic throat spray or throat lozenges, which may help relieve throat pain.
• Drink plenty of fluids. Fluids may help soothe an irritated throat. Warm fluids, such as tea or soup, or something cool, like ice pops, may help relieve throat pain.
• Get lots of rest.
• Do not smoke, and avoid secondhand smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

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 strep.

Scarlet fever is an infection that can happen with strep throat. The illness is named for its scarlet-colored rash. Scarlet fever is most common in children ages 5 to 15, but it can affect people of any age.