Background

• Group A Streptococcus

Clinical

• First symptoms often include a sore throat, headache, fever (>38.3 or higher is common) nausea/vomiting.

• After 12 to 48 hours the characteristic fine red rash develops (if you touch it, it feels like sandpaper). Typically, it first appears on the chest and stomach, rapidly spreading to other parts of the body. On more darkly-pigmented skin, the rash may be harder to spot than on children with lighter skin tones, although the ‘sandpaper’ feel should be present.

Further

• White coating on the tongue which peels a few days later, leaving the tongue looking red and swollen (known as ‘strawberry tongue’)

• Flushed red face, but pale around the mouth. The flushed face may appear more ‘sunburnt’ on darker skin than lighter skin

• Peeling skin on the fingertips, toes and groin area, as the rash fades

• Swollen glands in the neck

• Feeling tired and unwell

Diagnosis

• remains a clinical diagnosis

Treatment

The usual treatment for scarlet fever is a 10-day course of antibiotic, ideally Phenoxymethylpenicillin (see below for guidance on other antibiotic options). The fever will usually subside within 24 hours of starting antibiotics.

Resources

• Scarlet fever (NHS Choices), Scarlet fever (CKS)