What is Scarlet fever (Scarlatina)

Scarlet fever was once a very serious childhood disease, but now is easily treatable.

The streptococcal bacteria produces a toxin that causes a rash that appears one to two days after the onset of illness.

Statistics on Scarlet fever (Scarlatina)

It is a relatively mild disease, mainly infecting children.

Risk Factors for Scarlet fever (Scarlatina)

The main risk factors is infection with the bacteria that causes strep throat – one of the species of Streptococcus. A history of strep throat or scarlet fever in the community, neighborhood, or school may increase the risk of infection.

Progression of Scarlet fever (Scarlatina)

The incubation period is short, generally 1-2 days. The rash usually first appears on the neck and chest, then spreads over the body. It is described as “sandpapery” in quality. The texture of the rash is more important than the appearance in confirming the diagnosis. The rash can last for over a week. As the rash fades, peeling (desquamation) may occur around the finger tips, toes, and groin area.

How is Scarlet fever (Scarlatina) Diagnosed?

Typical clinical features can establish a diagnosis.

Prognosis of Scarlet fever (Scarlatina)

With proper antibiotic treatment, the symptoms of scarlet fever should resolve quickly (though the rash can last for up to 2-3 weeks before it is fully resolved).

Complications are rare with proper treatment.

These can include:

  • Acute rheumatic fever
  • Ear infection (otitis media)
  • Adenitis or abscess
  • Pneumonia
  • Sinusitis
  • Meningitis
  • Bone or joint problems (osteomyelitis or arthritis)
  • Liver damage (hepatitis)
  • Kidney damage (glomerulonephritis)

How is Scarlet fever (Scarlatina) Treated?

  • Penicillin is the best treatment and is give 4 times daily as 500mg. phenoxymethylpenicillin for 10 days.
  • Erythromycin 250mg 4 times daily should be given to individuals allergic to penicillin.
  • The patient remains infective for 10-21 days after the onset of the rash unless treated with penicillin – hence the patient should not attend school or work to avoid infecting other individuals.
  • Scarlet fever is a notifiable disease.


Scarlet fever (Scarlatina) References

  1. Kumar P, Clark M. Clinical Medicine. Fourth Ed. WB Saunders, 2002.
  2. MEDLINE Plus.

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