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Scarlet Fever Scarlet Fever
Scarlet fever is another one of those illnesses that occurs in people with strep throat. Scarlet fever is also called "scarlentina" though many... Scarlet Fever

by Kimberly Allen, RN

Scarlet fever is another one of those illnesses that occurs in people with strep throat.  Scarlet fever is also called “scarlentina” though many Drs use this term to describe a less severe form of scarlet fever.  It is most commonly diagnosed in children between 5-15 years of age.  Scarlet fever is highly contagious which made it one of the most feared illnesses in the past.  Scarlet fever was responsible for numerous epidemics taking the lives of many, especially children. Since the development of antibiotics the mortality rate has significantly improved.

Though rheumatic fever and scarlet fever both develop as a result of the group A streptococcus bacterium that causes strep throat scarlet fever develops because of a toxin called “pyrogenic toxin” that is produced by certain bacteria.  It is the pyrogenic toxin that produces the symptoms and not all group A streptococcus produce the toxin and not all children have the same sensitivity to it.  It is possible for 2 children in one family to have strep throat but one child may be sensitive to the toxin and develop scarlet fever while the other isn’t sensitive to the toxin  and doesn’t develop the illness.

The symptoms of scarlet fever usually develop with in 2 weeks after being exposed to the toxin.  The most recognizable symptom is the rash.  In the early stages it resembles a bad sunburn that has tiny bumps init that tends to itch.  Most often the rash will appear on the face and neck first.  Your childs face will have bright red coloring across their cheek, nose and forehead but the area around the mouth will be pale in color which then spreads down the chest and back before moving and affecting the body.  After six days the rash begins to fade and the affected areas begin to peel like from a sunburn.  In addition to the rash because scarlet fever develops in association with strep throat there will also be many symptoms that are also associated with strep throat including a severe sore throat with difficulty swallowing.  Most children also have a high fever, above 101F, as well as swollen , tender lymph nodes intheir neck.  They may also complain of nausea and vomiting, body aches and pains and a poor appetite.

If left untreated, scarlet fever can lead to numerous complications. The bacteria can spread throughout your childs body causing more serious infections including rhuematic fever.  Fortunately with the development of antibiotics treatment is much more accessable.  The most commonly used antibiotic is penicillin VK orally for at least 10 days.  If your child is allergic to penicillin your Dr has other options including erythromycin.  Your Dr may also recommend over the counter acetaminophen or ibuprofen to relieve symptoms like fever and pain.  Do not give your children aspirin, it can lead to more problems like Reye’s syndrome.  Once your child has been on antibiotics for 24 hours he/she is no longer considered contagious and may resume his/her activities as they are able to tolerate them.  They may need a couple days to regain their strength before returning to school.  It is crucial that your child complete the entire course of antibiotic therapy or the infection can return and lead to more serious problems.

The best way to prevent scarlet fever is to take measures to prevent any infection.  The single most important thing you can do is to wash your hands frequently and/or use an alcohol based hand sanitizer and teach children to do the same.  Always cover your mouth and nose with the crook of your elbow when coughing or sneezing as most conditions affecting the upper respiratory system are caused by inhaling infected droplets.  Another good precaution to take si to never share drinking glasses or utensils.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at