Scarlet Fever

Scarlet fever is an infectious disease that can develop with a strep throat. It usually occurs in school-age children and can spread from person to person (contagious). Scarlet fever seldom causes any long-term problems.


Scarlet fever is caused by the bacteria (Streptococcus pyogenes).


  • Sore throat, fever, and headache.

  • Mild abdominal pain.

  • Tongue may become red (strawberry tongue).

  • Red rash that starts 1 to 2 days after fever begins. Rash starts on face and spreads to rest of body.

  • Rash looks and feels like "goose bumps" or sandpaper and may itch.

  • Rash lasts 3 to 7 days and then starts to peel. Peeling may last 2 weeks.


Scarlet fever typically is diagnosed by physical exam and throat culture. Rapid strep testing is often available.


Antibiotic medicine will be prescribed. It usually takes 24 to 48 hours after beginning antibiotics to start feeling better.


  • Rest and get plenty of sleep.

  • Take your antibiotics as directed. Finish them even if you start to feel better.

  • Gargle a mixture of 1 tsp of salt and 8 oz of water to soothe the throat.

  • Drink enough fluids to keep your urine clear or pale yellow.

  • While the throat is very sore, eat soft or liquid foods such as milk, milk shakes, ice cream, frozen yogurts, soups, or instant breakfast milk drinks. Cold sport drinks, smoothies, or frozen ice pops are good choices for hydrating.

  • Family members who develop a sore throat or fever should see a caregiver.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver. Do not use aspirin.

  • Follow up with your caregiver about test results if necessary.


  • There is no improvement even after 48 to 72 hours of treatment or the symptoms worsen.

  • There is green, yellow-brown, or bloody phlegm.

  • There is joint pain or leg swelling.

  • Paleness, weakness, and fast breathing develop.

  • There is dry mouth, no urination, or sunken eyes (dehydration).

  • There is dark brown or bloody urine.


  • There is drooling or swallowing problems.

  • There are breathing problems.

  • There is a voice change.

  • There is neck pain.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.