Scarlet Fever in Children

Infectious Diseases

Scarlet fever in children – why does my child’s skin feel like sand paper?

 

Scarlet fever, like many infectious diseases, goes around seasonally. Some illnesses tend to crop up only in the winter and others in the summer. Scarlet fever and streptococcus pharyngitis (strep throat) seem to linger all year, with periodic outbreaks.

One such outbreak is appearing in Toronto this month, with a few cases being reported so far. I diagnosed strep throat a few times last week, and I suspect scarlet fever, a typical complication of strep throat, will appear in my office or emergency room soon. Strep throat is a frequent cause of high fever in children.

Once on proper antibiotics most children begin to improve in 12-24 hours.

What is scarlet fever?

Scarlet fever is a complication of strep throat infection. Infected children get a red, sandpaper-like rash over the body, a fever and sore throat. Though rare, it is most frequently seen in children 4-8 years of age.

Scarlet fever symptoms

  • Tonsillitis symptoms – sore throat, trouble swallowing
  • Fever
  • Headache
  • Abdominal pain, nausea or vomiting
  • Scarlet fever rash – red, sandpapery texture rash – typically develops within 1-2 days of the sore throat. The rash usually remains on the torso and does not spread to the face.
  • Swollen lymph nodes
  • Decreased appetite
  • Pastia lines – broken blood vessels in the folds of skin such as the elbow crease
  • ‘Strawberry tongue’ – beet red, swollen tongue with white coating

 

How is scarlet fever spread?

Strep infection spreads through:

  • Airborne droplets from a sneeze or cough of an infected person
  • From contaminated food
  • By coming in contact with the broken skin of an infected person
  • By touching contaminated objects such as utensils or cups of an infected person.

 

How is scarlet fever diagnosed?

Your physician will detect strep infection with a throat swab and by noting the characteristic pattern of illness.

 

Treatment

Scarlet fever requires antibiotics to treat the strep infection. Fever lowering medications and fluids may also be needed. There is no specific treatment for the rash. Once on proper antibiotics most children begin to improve in 12-24 hours.

 

Complications of scarlet fever

  • Abscesses in the throat
  • Ear infections
  • Pneumonia
  • Rheumatic fever
  • Meningitis
  • Infection in the blood (septicemia)

Prevention

  • Avoid exposure to other children who are sick
  • Caution your child to avoid sharing food and utensils with their friends
  • Wash hands frequently with soap and water or alcohol-containing solution

Dr. Dina Kulik, MD, FRCPC, PEM

Written By: Dr. Dina Kulik, MD, FRCPC, PEM

Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.

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