Scarlet fever is caused by certain strains of the group A streptococci bacteria (which also causes strep throat) and it is common to think of scarlet fever as strep throat with a rash. Symptoms usually develop about 1 to 7 days (incubation period) after being exposed to someone with strep throat or scarlet fever.
Scarlet fever is most common in children under 10 years old and begins with a fever and sore throat. Other symptoms can include vomiting, headache, chills and abdominal pain. Many children with this infection have a high fever initially, which may reach 103 to 104 degrees F. Without treatment, the fever may last 5 to 7 days, but usually quickly goes down within a day after starting antibiotic therapy.
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Although the sandpapery rash does not usually occur on the face, your child's forehead and cheeks may appear red and flushed. In addition to this flushed appearance, there is usually a pale area around his mouth (circumoral pallor).
Another common finding is dark, hyperpigmented areas on the skin, especially in skin creases. These areas are called Pastia's lines.
The fever and rash is usually also accompanied by a red, swollen throat and tonsils that can have a white coating of pus, swollen glands, decreased appetite and energy level.
Another common finding is a red and swollen tongue. At first, the tongue usually also has a white coating on it, and with the red swollen papillae of the tongue protruding through this white coating, it gives the appearance of a strawberry tongue.
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Although not as common, scarlet fever can also follow a strep infection of the skin. Symptoms would be similar to the classic scarlet fever described above, but instead of a throat infection, there would be signs of a skin infection, especially around a burn or wound.
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