Brooklyn Pediatric Infectious Diseases

Scarlet Fever Guideline

Scarlet fever most often affects children aged 2 to 9 years, since that child’s immunity at this age has not yet been strengthened. The scarlet fever vaccine does not exist. The causative agent of this infectious disease is streptococcus. Most people in adulthood are asymptomatic carriers of streptococcus, so scarlet fever is quite common. The child’s body catches the infection quite easily. After the disease, stable immunity is developed for the whole life.Scarlet Fever Guideline

Scarlet fever is a rather dangerous infectious disease, which is characterized by the development of severe complications, such as:

Earlier, in the absence of the necessary medications, scarlet fever often ended in death. Currently, due to the presence of effective antibacterial drugs, this disease most often proceeds in a mild form.


The name of this disease comes from the Latin (lat. Scarlatum – red, scarlet). It describes a characteristic symptom – a red rash on the skin, tongue, throat. Characteristic red rash of certain sizes and localization allows the doctor to differ scarlet fever from other diseases and make an accurate diagnosis.


A rash on the body and mucous membrane of the oral cavity and throat appears as a result of a reaction to an erythrogenic toxin secreted by streptococcus, the causative agent of scarlet fever. This toxin acts on the blood vessels, as a result of which they expand, rupture and form red spots.

With a mild rash, or in the early disease’s stages, scarlet fever can be confused with angina. The disease is characterized by all the symptoms observed with tonsillitis. This includes plaque coating of the tonsils with an increase in their size, redness of the palate and pharynx, enlargement of the cervical and axillary lymph nodes, as well as chills and fever. If summarized, the following symptoms are characteristic of scarlet fever:

What does the appearance of a rash mean?

The rash does not appear immediately, but develops gradually and reaches its maximum severity on the 3-5th day of the disease. Its appearance means that streptococci have already begun to actively release the toxin and it is carried by the blood throughout the body. As a result, it affects the walls of blood vessels. Rashes can appear in various body areas: face, corpus, armpits, inguinal folds, neck, and etc. On the 6-7th day of the disease, the rash turns pale, the skin in the affected areas begins to peel and slide off. It is considered a favorable symptom claiming the child is recovering.

Tongue state

If the mouth of a patient is examined, a doctor can see a red flaming tongue with enlarged papillae, a bright red palate, throat with enlarged tonsils. Doctors call such a throat a “flaming pharynx.”


During the course, the disease goes through several stages from the incubation period to complete recovery. Let’s consider all stages in order:

In the absence of the necessary treatment, scarlet fever can cause severe complications, such as myocarditis (inflammation of the heart muscle), glomerulonephritis (kidney damage), purulent foci in the liver and kidneys can develop.


Treatment for mild scarlet fever does not always require antibiotics. However, the decision on taking antibacterial drugs and their selection is made only by a pediatrician. Antibiotics of the penicillin group are prescribed in the case of moderate and severe forms. In case of allergic reactions to antibiotics of this group, the doctor prescribes drugs of another group. It is also mandatory to take symptomatic drugs that help reduce inflammatory reactions, antipyretic, antihistamines, as well as vitamins and drugs to reduce symptoms of intoxication. Abundant drinking is recommended (tea, herbal teas, lemonades, etc.).

Is it possible to treat scarlet fever at home?

Self-medication in a child is contraindicated. Only the pediatrician decides on the appointment of certain medications.

Since a patient with scarlet fever is contagious from the first day of the disease, he/she must be isolated to prevent the infection distribution. Inpatient treatment is indicated in the following cases:


Unfortunately, there is no vaccine for scarlet fever, so the main methods of prevention are to isolate the patient, as well as establish weekly quarantine in the classroom of a preschool or school institution.

A child who has had scarlet fever at home is allowed to attend kindergarten or school only 22 days after the disease onset. If the child is discharged from the hospital, he can start attending classes only 12 days after leaving a hospital.

One of the effective methods of preventing the disease is to observe personal hygiene rules, such as washing hands before eating, disinfecting personal items, baby toys. It is recommended to avoid visiting overcrowded places.

Category: Health Care