August 29, 2016
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Scarlet Fever (Scarlatina) (cont.)

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How do physicians diagnose scarlet fever?

In most cases, the patient's history and physical exam will result in a presumptive diagnosis of scarlet fever. However, throat swabs (or rarely, swabs from a wound or other sites of infection) are cultured to determine if GABHS are present. Unfortunately, there are many other infections that can cause both a skin rash and a fever. Isolation of GABHS usually is enough to confirm the diagnosis of scarlet fever. If GABHS is not identified, the symptoms are likely due to another underlying problem.

What is the treatment for scarlet fever?

The treatment for scarlet fever is antibiotics that are effective against GABHS. Usually about 10 days of an oral penicillin medication (for example, amoxicillin) is effective early treatment. Rarely, some patients may need to be treated with a single injection of penicillin G benzathine (Bicillin L-A). This is most commonly indicated for a patient who is unable to retain oral antibiotics. Other effective antibiotics are members of the cephalosporin family (for example, cephalexin [Keflex]). A recent outbreak in China showed GABHS resistance to the common antibiotics used to treat scarlet fever. Antibiotics may prevent complications of scarlet fever such as rheumatic fever.

What are complications of scarlet fever?

Complications from scarlet fever may include kidney disease (termed post-streptococcal glomerulonephritis) and rheumatic fever (an inflammatory disease caused by antibody cross-reactivity that the effects the heart, joints, skin, and brain). Rheumatic complications can begin about two to three weeks after the initial infection; children between the ages of 6 and 15 are most susceptible to rheumatic fever development. Glomerular complications may begin about one to two weeks after throat infection or about three to six weeks after skin infection and usually cause more problems in adults than children.

Medically Reviewed by a Doctor on 2/22/2016


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