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Scarlet fever: what is it? Causes, Symptoms and Treatment

The scarlet fever is a contagious infection caused by a type of bacteria streptococcus Scarlet fever is frequently manifested by a sore throat (strep throat), followed by a rash, high fever and lesions on the tongue.

The disease most often affects children aged 5 to 15, but adults can also be affected.

In rare cases of untreated scarlet fever, complications may occur. These complications affect the ears, kidneys or joints.

What are the causes of Scarlet fever?

The bacteria responsible for scarlet fever are frequently found in the throat or on the skin. It can produce toxins responsible for rashes and lesions on the tongue.

The disease is transmitted from person to person by droplets suspended in the air when an infected person coughs or sneezes or by contact with objects contaminated by these secretions (glasses, cooking utensils, toys, hands, etc.).


Complications of scarlet fever

The complications of untreated scarlet fever are rather rare. In the early stages of the disease, the bacteria can sometimes cause ear infections (otitis), sinus infection (sinusitis), pneumonia, or more rarely an abscess in the throat or meningitis.

In the later stages of the disease, scarlet fever can very rarely cause serious complications, such as rheumatic fever (a serious condition that can cause heart damage, joint pain and shortness of breath) or glomerulonephritis (inflammation of the kidneys).

Diagnosis of the Scarlet fever

If doubt persists after the clinical examination, a rapid test (RDT) for strep throat may be used.

To perform this test, the doctor rubs a cotton swab into the patient’s throat and places it in a solution. After a few minutes, the test will reveal the presence or not of a bacterium in the throat, including streptococcus. A sample can also be sent to a laboratory to be analyzed more accurately.

The symptoms of scarlet fever

The symptoms of scarlet fever usually appear 2 to 4 days after exposure to the bacteria, the time of the incubation period.

  • High fever (at least 38.3ºC or 101ºF).
  • An intense sore throat leading to difficulty swallowing (dysphagia).
  • Redness and swollen throat.
  • Swelling of the ganglions of the neck.

Sometimes add:

  • Headaches
  • Stomach pain
  • Nausea or vomiting.

One to two days later:

  • reddish rash (a diffuse redness with small red pimples) that first appears on the neck, face and flexion folds (armpits, elbows, thighs). The redness fades at the pressure of the finger. The eruptions can spread to the rest of the body in 2 or 3 days (upper thorax, lower abdomen, face, extremities). The skin then takes the texture of sandpaper.
  • whitish coating on the tongue. When it disappears, the tongue and the palate turn bright red, like a raspberry.
  • peeling skin.

There are also mild forms of the disease. This form of scarlet is manifest by:

  • A less important fever
  • Rashes that is pinker than red and localized to folds of flexion.
  • The same symptoms as the normal form of scarlet fever for the throat and tongue.

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People at risk for Scarlet fever

  • Children from 5 to 15 years old. (Children under 2 years are often protected against scarlet fever by the antibodies transmitted by their mother during pregnancy, via the placenta).

Risk factors

  • The infection spreads more easily among people who live in close contact, for example between family members or among students in the same class.

Prevention of scarlet fever

Can we prevent scarlet fever?
Since scarlet fever is caused by a bacterial infection, the best way to prevent the disease is to observe basic hygiene measures.


Basic preventive measures
Strict hygiene measures can help protect against most infections, such as scarlet fever.

Hand washing. Wash your hands with soap, especially after contact with an infected person or touching an object handled by an infected person. Wash hands often with young children. Teach children to wash their hands themselves as soon as possible, especially after they have coughed, sneezed or after they have bled.

The use of the handkerchief. Teach children to cough or sneeze into a tissue.

Cough or sneeze into the crook of the elbow. Teach children to cough or sneeze in the crook of the elbow rather than in the hand.

Disinfection of transmission surfaces. Clean toys, faucets and door handles thoroughly, preferably with an alcohol-based cleaner.

Medical treatment of scarlet fever

Antibiotics (usually penicillin or amoxicillin). Antibiotic treatment can reduce the duration of the disease; prevent complications and spread of infection. The treatment should continue for the prescribed duration (usually ten days), even if the symptoms have disappeared. Interrupting antibiotic therapy can lead to relapse, cause complications and contribute to antibiotic resistance.

After 24 hours of antibiotic treatment, patients are usually no longer infectious.


To reduce discomfort and pain in children:

  • Promote quiet activities. Even if it is not necessary for the child to keep the bed all day, he must rest.
  • Give often to drink: water, juice, soup to avoid dehydration. Avoid too acidic juices (orange, lemonade, grape), which accentuate the sore throat.
  • Offer soft foods (mashed potatoes, yoghurt, ice cream, etc.) in small amounts, 5 or 6 times a day.
  • Keep the air humid because cold air can irritate the throat. Preferably use a cool mist humidifier.
  • Keep ambient air free of irritants, such as household products or cigarette smoke.
  • To relieve throat pain, invite the child to gargle a few times a day with 2.5 mol (½ teaspoon) of salt diluted in a glass of warm water.
  • Suck lozenges to soothe sore throat (for children over 4 years old).
  • Offer acetaminophen or paracetamol (Doliprane, Tylenol, Tempra, Panadol, etc.) or Ibupfofen (Advil, Motrin, etc.) to relieve the pain caused by sore throat and fever
WARNING. Never give ibuprofen to a baby under 6 months old and never give acetylsalicylic acid (ASA), such as Aspirin, to a child or teenager.

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