Scarlet Fever

Question 1

Who is scarlet fever most common in and what is the peak age?

Answer 1

Children aged 2 - 6 years old and the peak age is 4 years old.

Question 2

What is the cause of scarlet fever?

Answer 2

A reaction to erythrogenic toxins produced by Group A haemolytic streptococci (usually Streptococcus pyogenes)

Question 3

What is the incubation period of scarlet fever?

Answer 3

2-4 days

Question 4

What are the typical presenting features?

Answer 4

• Fever
• Malaise
• Tonsillitis
• ‘Strawberry’ tongue
• Rash - fine punctate erythema (‘pinhead’) which generally appears first on the torso and spares the face although children often have a flushed appearance with perioral pallor. The rash often has a rough ‘sandpaper’ texture. Desquamination occurs later in the course of the illness, particularly around the fingers and toes

Question 5

Answer 5

Question 6

How do you diagnose scarlet fever?

Answer 6

Throat swab should be taken.

NOTE: Antibiotics should be started immediately without waiting for the results of the swab.

Question 7

How do you manage scarlet fever?

Answer 7

1. Oral Penicillin V
2. Penciillin Allergy: Azithromycin.
3. Children can return to school 24 hours after commencing antibiotics.
4. It is a notifiable disease.

Question 8

What are some complications of scarlet fever?

Answer 8

1. Otitis media - the most common complication
2. Rheumatic fever - typically occurs 20 days after infection.
3. Acute glomerulonephritis - typically occurs 10 days after infection.