Scarlet fever

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.

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.

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 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.

• If the doctor prescribed antibiotics for your child, give them as directed. Do not stop using them just because your child feels better. Your child needs to take the full course of antibiotics.
• Until your child no longer has a fever and until they have taken antibiotics for at least 12 hours, have your child avoid contact with other people, especially infants and other children. Do not send your child to school or day care. Keep your child's drinking glass and eating utensils separate. Wash these items well in hot, soapy water.
• Have your child age 8 or older gargle with warm salt water once an hour to help reduce swelling and relieve pain in the throat. Use 1/2 teaspoon (2.5 mL) of salt mixed in 1 cup (250mL) of warm water.
• Give your child an over-the-counter pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Do not use ibuprofen if your child is less than 6 months old unless the doctor gave you instructions to use it. Be safe with medicines. Read and follow all instructions on the label.
• Be careful when giving your child 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 giving your child more than the recommended dose. Too much acetaminophen (Tylenol) can be harmful.
• Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness.
• If your child is younger than age 2, ask your doctor if you can give your child numbing medicines. An over-the-counter anesthetic throat spray or throat lozenges may help relieve throat pain. Do not give lozenges to children younger than age 4.
• Give your child plenty of fluids to drink. 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.
• Make sure your child gets lots of rest.
• Keep your child away from smoke. Do not smoke or let anyone else smoke around your child or in your house.