Understanding Scarlet Fever: Symptoms, Diagnosis, and Treatment for Your Child
Doctor explains the causes, symptoms, diagnosis, and treatment of scarlet fever in children. Learn how to spot the signs, why early treatment is crucial, and how to prevent complications.
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Topic Breakdown
If your child has developed a rough-feeling red rash, sore throat, and fever, they might have something called scarlet fever. In this blog post, we'll cover what it is, who gets it, its symptoms, diagnosis, and treatment.
Scarlet fever is caused by a tiny germ or bacteria called Streptococcus pyogenes, also known as group A strep. This germ causes several illnesses, including skin infections, chest infections, and infections of the heart. Sometimes, the bacteria only cause a sore throat without the rash, often referred to as strep throat or simple tonsillitis. In scarlet fever, however, the streptococcus bacterium releases toxins that spread through the body, causing the rash. If left untreated, these toxins can cause problems in the kidneys and heart, even years later.
Scarlet fever is most common in children under 10 years old, with four-year-olds being the most likely to catch it. In fact, 9 out of 10 cases in the UK occur in children under 10. Although adults can get scarlet fever, it is very unusual. The symptoms and treatment are the same for both children and adults. Scarlet fever used to be very common in the 1800s and early 1900s due to overcrowding and poor living conditions. It was the leading cause of death in children during that time. However, as general health measures improved, it became much rarer. Recent outbreaks in the UK have usually occurred in schools, but antibiotics can now treat scarlet fever very effectively.
There are several key symptoms of scarlet fever that you should be aware of. These include a high temperature or fever, a sore throat, and a classical finding known as "strawberry tongue," where the tongue appears red with tiny white spots. After a couple of days, the tongue can swell and look a bit larger than usual, sometimes referred to as "beef tongue." You may also notice a rough-feeling rash on the chest, tummy, and cheeks, which feels like sandpaper. This rash usually appears 12 to 48 hours after infection. In children with white skin, the rash can look red, but this may not be the case in individuals with darker skin. By this stage, the combination of a sore throat, rough-feeling rash, and red tongue makes the diagnosis of scarlet fever quite obvious to doctors. If left untreated, the rash and sore throat will fade over about 10 days, but the skin can sometimes peel, similar to sunburn.
The diagnosis of scarlet fever can generally be made based on the clinical picture. A child with a high temperature, sore throat, red tongue, and rough-feeling red rash on their chest and tummy would point towards a scarlet fever diagnosis, and tests are typically not necessary. If there is any doubt, a doctor can take a throat swab, which looks like a long cotton bud. However, the results take a few days to come back, so if scarlet fever is suspected, it's usually best to start antibiotic treatment first. There is also a blood test called the anti-streptolysin O titer test (ASO) that can detect the scarlet fever germ, but it only becomes positive one week to one month after the infection, so it won't tell you if someone has scarlet fever right now.
The best treatment for scarlet fever is antibiotics, as it is caused by bacteria and can lead to serious complications without treatment. The antibiotic penicillin is the most effective and requires a long course of about 10 days. It's crucial to complete the full course of antibiotics, even if the child seems to be getting better. If the child is allergic to penicillin, other antibiotics like erythromycin or clarithromycin can be considered. General treatment to relieve symptoms is also important. Keeping the child's fluid levels up is essential, and paracetamol can help bring down a high temperature, although it doesn't treat the underlying infection.
Complications of scarlet fever are rare but can be serious. Early complications, which occur within days, include ear infection, throat infection, abscesses, sinus infection, pneumonia, and meningitis. Later complications, which happen weeks or months after the infection, include rheumatic fever, which can damage the heart, and kidney damage known as glomerulonephritis. This is why it's important to take the full course of antibiotics.
Scarlet fever is contagious and can be spread through coughs, sneezes, and close contact. Children with scarlet fever should be kept off school and away from others for 24 hours after starting antibiotics. Once a person has had scarlet fever, they are unlikely to get it again, as they become immune to the bacteria, although repeated attacks are possible due to different types of streptococcal bacteria.
If you have any concerns about your child, please see a doctor. This post is for educational purposes and not clinical advice. If you found this information helpful, please like, comment, and subscribe to the channel for weekly medical education videos. If you're interested in scaling your medical brand on YouTube or sponsoring our videos, please get in touch. Thank you for reading, and stay healthy!
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