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Scarlet Fever in Children

When your child has a strep throat, there’s a chance that they’ll get a rash known as scarlet fever.

The symptoms of scarlet fever begin with a sore throat, a fever of 101 to 104 degrees Fahrenheit (38.2–40 degrees Celsius), and headache. This is followed within 24 hours by a red rash covering the trunk, arms and legs.

Scarlet fever rash

The rash is slightly raised, which makes the skin feel like fine sandpaper. Your child’s face may turn red, too, with a pale area around their mouth. This redness will disappear in 3 to 5 days, leaving peeling skin in the areas where the rash was most intense (neck, underarms, groin, fingers and toes). They may also have a white coated, then reddened, tongue and mild abdominal pain.

Treatment for scarlet fever

Call your pediatrician whenever your child complains of a sore throat, especially if they also have a rash or fever. The doctor will examine them and swab his throat to check for strep bacteria. If strep throat is found, an antibiotic (usually penicillin or amoxicillin) will be given. If your child takes the antibiotic by mouth rather than an injection, it’s extremely important to complete the entire course; shorter treatment sometimes results in a return of the disease.

Most children with strep infections respond very quickly to antibiotics. The fever, sore throat, and headache usually are gone within 24 hours. The rash, however, will remain for about 3 to 5 days.

If your child’s condition does not seem to improve with treatment, notify your pediatrician. If other family members develop a fever or sore throat at this time—with or without a rash—they, too, should be examined and tested for strep throat.

Complications of scarlet fever in children

If not treated, scarlet fever (like strep throat) can lead to ear and sinus infections, swollen neck glands and pus around the tonsils. The most serious complication of untreated strep throat is rheumatic fever, which results in joint pain and swelling and sometimes heart damage. Very rarely, the strep bacteria in the throat can lead to glomerulonephritis, or inflammation of the kidneys, causing blood to appear in the urine and sometimes high blood pressure.

More information

Last Updated
Adapted from Caring for Your Baby and Young Child: Birth to Age 5 7th Edition (Copyright © 2019 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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