Scarlet fever

Question 1

organism

Answer 1

Group A haemolytic streptococci (usually Streptococcus pyogenes)

Question 2

age

Answer 2

aged 2 - 6 years with the peak incidence being at 4 years

Question 3

transmission

Answer 3

the respiratory route by inhaling or ingesting respiratory droplets or by direct contact with nose and throat discharges, (especially during sneezing and coughing).

Question 4

incubation

Answer 4

incubation period of 2-4 days

Question 5

presentation

Answer 5

fever: typically lasts 24 to 48 hours
malaise, headache, nausea/vomiting
sore throat
‘strawberry’ tongue
rash

Question 6

pattern of presentation of rash

Answer 6

1st torso and spares palms and soles

flushes appearance

sandpaper texture skin

Question 7

Ddx

Answer 7

throat swab

Question 8

Mx

Answer 8

oral penicillin V for 10 days

patients who have a penicillin allergy should be given azithromycin

children can return to school 24 hours after commencing antibiotics

scarlet fever is a notifiable disease

Question 9

complications

Answer 9

otitis media: the most common complication

rheumatic fever: typically occurs 20 days after infection

acute glomerulonephritis: typically occurs 10 days after infection

invasive complications (e.g. bacteraemia, meningitis, necrotizing fasciitis) are rare but may present acutely with life-threatening illness