Video:Scarlet fever
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Description
Scarlet fever is a widespread rash that occurs during a strep infection.[1]
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Signs and symptoms1
Symptoms typically begin with a sore throat and fever, generally 2 to 5 days after contact with the infection.[1][2]
Signs and symptoms2
In addition to large tonsils and a red throat, small red spots on the roof of the mouth may be visible.[3]
Tongue
The tongue may appear red and bumpy like a strawberry.[3]
Cheeks
The cheeks may look flushed.[3][4]
Glands
Glands in the neck may be enlarged and tender.[1]
Other symptoms
Other symptoms include headache, body ache, nausea, and a tummy ache.[1]
Rash1
The classic scarlet fever rash is generally first noticed on the neck and torso before it spreads to the arms and legs.[5]
Rash2
It generally looks red on white skin, though might be difficult to see on darker skin.[1] It typically feels like sandpaper and can be itchy.[6] The palms of hands and soles of feet are typically not involved.[5]
Skin folds
A more intense redness may be noticed in skin folds.[7]
Skin shedding
It takes around a week for the main rash to disappear, following which the skin sheds in fine flakes.[1]
Cause1
Scarlet fever typically follows a strep throat, though may occur from strep infected burn and surgical wounds.[3]
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Cause
The rash occurs as a result of capillary damage by erythrogenic toxin-producing strep.[8]
Cause2
The bacteria are usually spread by coughing or sneezing.[4][8]
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Cause3
It can also be spread when a person touches a contaminated object then touches their mouth or nose.[4]
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Diagnosis
Diagnosis may be confirmed by a throat swab or by rapid streptococcal antigen test.[9] A blood test showing a raised anti-streptolysin O confirms recent infection.[3]
Differential
Scarlet fever may appear similar to Kawasaki disease[3][7]
Toxic shock
Erysipelas
Measles
Chickenpox
Hand-foot-and-mouth disease
and hand-foot-and-mouth disease.[3][7]
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Prevention
There is no vaccine.[4] Prevention is by handwashing, not sharing personal items, and staying away from people who are sick.[4] Up to 80% of children develop lifelong immunity by the age of 10 years.[9]
Treatment1
Treatment is with antibiotics, which prevent most complications.[4] Generally, 10 days of penicillin is the first choice of treatment.[1] Alternatives include amoxicillin, first-generation cephalosporin, clindamycin, or erythromycin.[3][7]
Treatment2
Drinking cool water, eating soft foods, taking medications for fever, and applying calamine lotion to the skin may help with symptoms.[10]
Complications
Outcomes are good if treated.[3] Long-term complications may include rheumatic heart disease, kidney disease, or arthritis.[4]
Epidemiology1
Scarlet fever most commonly affects children age 1 to 15 years.[4][11] Low and middle income countries see a greater number of cases.[7]
Epidemiology2
It is seen more frequently when children are in school and in the winter.[1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Michaels, Marian `G.; Williams, John V. (2023). "13. Infectious diseases". In Zitelli, Basil J.; McIntire, Sara C.; Nowalk, Andrew J.; Garrison, Jessica (eds.). Zitelli and Davis' Atlas of Pediatric Physical Diagnosis (8th ed.). Philadelphia: Elsevier. pp. 468–469. ISBN 978-0-323-77788-9. Archived from the original on 8 April 2023. Retrieved 29 June 2023.
- ↑ "Scarlet fever: symptoms, diagnosis and treatment". GOV.UK. Archived from the original on 11 December 2022. Retrieved 11 December 2022.
- ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "14. Bacterial infections". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 259-260. ISBN 978-0-323-54753-6. Archived from the original on 13 December 2022. Retrieved 11 December 2022.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 "Scarlet Fever: All You Need to Know". Center for Disease Control and Prevention. 31 October 2022. Archived from the original on 8 December 2022. Retrieved 9 December 2022.
- ↑ 5.0 5.1 Stevens, Dennis L.; Bryant, Amy E.; Hagman, Melissa M. (2020). "274. Nonpneumococcal streptococcal infections and rheumatic fever". In Goldman, Lee; Schafer, Andrew I. (eds.). Goldman-Cecil Medicine. Vol. 2 (26th ed.). Philadelphia: Elsevier. p. 1873. ISBN 978-0-323-55087-1. Archived from the original on 14 December 2022. Retrieved 14 December 2022.
- ↑ Denny, George O.; Cohen, Bernard A. (2022). "7. Reactive erythema". In Cohen, Bernard A. (ed.). Pediatric Dermatology. Philadelphia: Elsevier. p. 191-192. ISBN 978-0-7020-7963-4. Archived from the original on 14 December 2022. Retrieved 14 December 2022.
- ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 Pardo, Salvatore; Perera, Thomas B. (2022). "Scarlet Fever". StatPearls. StatPearls Publishing. PMID 29939666. Archived from the original on 23 March 2022. Retrieved 9 December 2022.
- ↑ 8.0 8.1 Stevens, Dennis L.; Bryant, Amy E. (2022). "21. Life-threatening skin and soft tissue infections". In Jong, Elaine C.; Stevens, Dennis L. (eds.). Netter's Infectious Diseases (2nd ed.). Elsevier. p. 95. ISBN 978-0-323-71159-3. Archived from the original on 11 December 2022. Retrieved 11 December 2022.
- ↑ 9.0 9.1 "Scarlet fever: Causes, Treatment, and Outcome — DermNet". dermnetnz.org. Archived from the original on 18 August 2022. Retrieved 9 December 2022.
- ↑ "Scarlet fever". nhs.uk. 19 October 2017. Archived from the original on 8 December 2022. Retrieved 9 December 2022.
- ↑ Paller, Amy S.; Mancini, Anthony J. (2022). "16. Exanthemous diseases of childhood". Paller and Mancini - Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence. St. Louis, Missouri: Elsevier. pp. 449–450. ISBN 978-0-323-54988-2. Archived from the original on 19 December 2022. Retrieved 19 December 2022.