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Scarlet Fever - Symptoms, Causes, Risk Factors, Diagnosis, and Treatment

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Scarlet Fever - Symptoms, Causes, Risk Factors, Diagnosis, and Treatment

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Scarlet fever is an infectious disease caused by a bacteria called group A streptococcus. Read the article to know about the causes, symptoms, and treatment.

Written by

Dr. Lochana .k

Medically reviewed by

Dr. Amit Jauhari

Published At May 28, 2020
Reviewed AtMay 9, 2023

What Is Scarlet Fever?

Scarlet fever is otherwise known as scarlatina. Scarlet fever is an infection that usually develops in people who might have an existing strep throat infection. The typical features of scarlet fever are bright red rashes on the body. They are often accompanied by sore throat and fever.

The same bacteria that cause strep throat are also known to cause scarlet fever. Scarlet fever mostly occurs in children between the ages of 5 and 15 years. It is a serious childhood illness.

  • The infection spreads from one person to another person through the droplets expelled by an infected person during coughing or sneezing.

  • Scarlet fever has more chances of spreading through direct contact with the fomites.

What Are Fomites?

When an inanimate object or item is infected by the sputum or any other discharges expelled by the infected person, the infectious germs may still remain in the objects. The objects may include desks, handkerchiefs, soaps, glasses, plates, utensils, clothes, cups, spoons, doorknobs, pencils, pens, bath faucet handles, toilet flush, handrails, buttons of the lift machine, television remote controls, touch screens, phones, keyboards, and coffeepot handles. The germs residing in these objects cannot be seen with our naked eye. The spreading of infection by fomites is known to be proved in many theories of infection. Hence it should be frequently cleaned to avoid spreading to other family members, friends, and classmates.

What Causes Scarlet Fever?

Scarlet fever is caused by a similar type of bacteria that is causing strep throat. In scarlet fever, a toxin is released by the bacteria. This toxin produces red rashes on the tongue. The normal incubation time taken for scarlet fever is usually two to four days. The incubation period is the time taken for the symptoms to show or express.

What Are the Risk Factors of Scarlet Fever?

Children aged five to fifteen years are more likely to get affected by scarlet fever than other people. This may be due to the improper development of the immune system. The germs causing scarlet fever can easily spread through direct contact with the droplets from the affected person.

What Are the Symptoms of Scarlet Fever?

The signs and symptoms might vary depending on the severity of the disease.

  • Red Rashes: The rashes of scarlet fever look like sunburns and feel like sandpaper rubbing. It usually begins on the face or neck and spreads to the trunk, arms, and legs. When the pressure is applied to the reddened part of the skin, it will turn pale.

  • Red Lines: The parts of the skin around the groin, knees, armpits, elbows, and neck usually become a deeper red than the surrounding rash.

  • Flushed Face: The face might appear flushed. A pale ring is seen around the mouth. Flushed skin appearance is because of the tiny blood vessels lying beneath the skin. These blood vessels either dilate or widen. When these blood vessels expand, they are rapidly filled with more blood. This can make the skin appear red or pink. This effect is seen more in regions of the body where the blood vessels are seen closest to the skin. This might include cheeks and chest. The skin that is flushed may feel hot to the touch. This may be accompanied by a mild burning sensation. It does not cause harm most of the time. But it is recommended to check with the doctor.

  • Strawberry Tongue: The tongue generally looks bright red and bumpy. The tongue becomes enlarged, swollen, and red. This might resemble the strawberry fruit. It is often covered with a white coating in the early stages of the disease. When a patient develops a strawberry tongue, it is advisable to consult a doctor immediately to know the underlying cause. The doctor will perform a few tests for confirmation.

The symptoms of rashes are known to last about a week. When these signs and symptoms have subsided, the skin affected by the rash often peels. Other signs and symptoms associated with scarlet fever are:

  • Very high fever of 101 degrees Fahrenheit (38.3 Celsius) or higher. It is often associated with chills.

  • A sore throat may be present. Sometimes it is seen with white or yellowish patches.

  • Difficulty in swallowing.

  • Swelling and tenderness along the lymph nodes (enlarged glands in the neck).

  • Vomiting.

  • Headache.

  • Nausea.

What Are the Complications of Scarlet Fever?

The bacteria causing the infection may further spread through blood, kidneys, and lungs. If scarlet fever is left untreated, it may cause other complications such as:

  • Rheumatic fever (which can involve the heart, joints, and nervous system).

  • Tonsillitis.

  • Skin infection.

  • Kidney diseases.

  • Abscess formation.

  • Infections of the lung.

  • Severe middle ear infections.

How Is Scarlet Fever Diagnosed?

The diagnosis of scarlet fever is made through detailed history taking and physical examination of the patients. The healthcare provider will check the condition of the throat, tonsils, and tongue clinically. They may advise the patient for a swab test. If there are no bacterial infections, then some other factors might be responsible for the illness.

How Is Scarlet Fever Treated?

Treatment for scarlet fever involves primarily providing relief from the symptoms. Primary care to manage the symptoms of scarlet fever includes:

  • To provide adequate supplements of fluids.

  • Patients are advised to drink plenty of water.

  • To perform salt water gargling.

  • Humidification of the air is required. Using a cool-mist humidifier to eliminate the dry air is essential.

  • Patients are advised to avoid ice creams and cold items.

  • It is recommended to avoid any products that could irritate the throat.

When the affected child is suspected of having scarlet fever, the doctor will prescribe certain antibiotics. Ibuprofen or Acetaminophen (Paracetamol) can be used to control the fever. This might also reduce throat pain.

How Can Scarlet Fever Be Prevented?

There are no vaccines found to prevent scarlet fever. The best prevention strategies for scarlet fever are some of the standard precaution protocols to be followed against infections:

  • It is advised to wash hands properly. It is essential to wash hands for a minimum of 15 seconds. Parents should teach their children how to wash their hands thoroughly with warm and soapy water. After washing hands, it is necessary to wipe with clean towels.

  • Do not share utensils or food with the affected person as it is highly contagious. As a cleanliness measure, the child should not share drinking glasses or other eating utensils with friends, family members, or classmates.

  • It is mandatory to cover the mouth and nose when coughing and sneezing to prevent the potential spread of germs from one person to another.

  • It is advisable to wash the toys used by the affected child in hot soapy water or using a dishwasher.


Scarlet fever is a contagious bacterial infection that could affect the young population. It is caused by a bacteria called group A streptococcus. This condition causes fever, chills, and rashes all over the body. Certain antibiotics are used in the treatment of scarlet fever. It is recommended to follow necessary preventive measures to avoid the condition.

Frequently Asked Questions


Who Is at Risk for Scarlet Fever?

Children aged 5 to15 years are at a greater risk of getting affected by scarlet fever. This is because of improper development of the immune system in young children. The germs causing scarlet fever (streptococcus bacteria) can quickly spread through direct contact with the droplets from the affected person.


What Is the First Symptom of Scarlet Fever?

The first symptom of scarlet fever is a high fever that may rise to 104 degree Fahrenheit temperature with a sore throat. At times the throat may appear red with white to yellowish patches. Other symptoms include red rashes and lines on various body parts, a strawberry appearance on the tongue, and a flushed face (reddish skin color).


Where Is Scarlet Fever Found?

Rashes of scarlet fever appear on the face and neck and spread to the chest, trunk, arms, and legs. In later stages, these rashes spread over the entire body. Symptoms of scarlet fever can also appear in the throat, causing a sore throat and tongue, causing the deep red color of the tongue


Does Scarlet Fever Need Treatment?

Some cases of scarlet fever may or may not need treatment. Mild symptoms of scarlet fever usually heal on their own. However, it is always better to consult a doctor. In severe cases, scarlet fever is treated with medications like antibiotics. In case of antibiotic allergies, alternative medicines are used.


What Does Scarlet Fever Look Like?

The rashes usually begin as small, flat blotches that slowly become fine bumps that feel like sandpaper. The cheeks look flushed (pink and rosy), with pale skin around the mouth. Elbow, underarm, and groin skin creases may appear reddish than the rashes. These rashes may spread to the entire body as the disease progresses.


What Kills Scarlet Fever?

Doctors treat scarlet fever with a ten-day antibiotic course. These antibiotic medications fight the bacteria causing scarlet fever and kill them. In case of any allergies to antibiotic medications, alternative medicines are used to kill the bacteria causing the infection.


What Happens if One Fails to Seek Treatment for Scarlet Fever?

Ignoring the condition can make the situation worse. Rashes of scarlet fever can spread over the entire body. Symptoms in the throat can become worse, making swallowing food difficult. Failing to get the symptoms in control can spread the infection to other people.


How Long Is Scarlet Fever Contagious?

Symptoms of scarlet fever last for four to seven days. A person infected with scarlet fever can spread the infection to others up to six days before they get symptoms and until 24 hours after taking the first dose of antibiotics. Failing to take medications (prescribed antibiotics) can spread the infection for two to three weeks after the symptoms start.


Does Scarlet Fever Affect the Heart?

Yes. Scarlet fever can affect the heart. Scarlet fever is a severe condition affecting children. However, antibiotic treatments have made it less threatening. Untreated scarlet fever can result in more serious conditions affecting the heart, kidneys, and other body parts.


Can Scarlet Fever Cause Sepsis?

Yes. Scarlet fever can cause sepsis. Bacteria causing the infection can enter the bloodstream and cause blood poisoning and septicemia. The complications can prove to be life-threatening. Usually, scarlet fever symptoms subside and go away after the doctor prescribes antibiotic medications.


What Antibiotics Are Used for Scarlet Fever?

Scarlet fever is usually treated with a course of antibiotics for ten days. Medications like Penicillin or Amoxicillin tablets are used to treat scarlet fever. Liquid antibiotics may be used for young children. Alternative antibiotics like Erythromycin are given to people who are allergic to Penicillin.


Does Scarlet Fever Affect the Liver?

Scarlet fever can affect different organs of the body, including the liver, if left untreated. Studies show severe scarlet fever not treated with antibiotic medications can affect the liver and impair liver functioning. Hence, it is always advised to consult a doctor as soon as the symptoms of scarlet fever start appearing on the face and body.
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Dr. Lochana .k
Dr. Lochana .k



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