Scarlet fever is a disease caused by an infection with bacteria in the group A Streptococcus (the same bacteria that cause strep throat).
Scarlet fever was once a very serious childhood disease, but now it is easy to treat. The streptococcal bacteria that cause it produce a toxin that leads to the hallmark red rash of the illness.
The main risk factor for getting scarlet fever is infection with the bacteria that cause strep throat. A history of strep throat or scarlet fever in the community, neighborhood, or school may increase the risk of infection.
The time between infection and symptoms is short, generally 1 - 2 days. The illness typically begins with a fever and sore throat.
The rash usually first appears on the neck and chest, then spreads over the body. People say it feels like sandpaper. The texture of the rash is more important than the appearance to confirm the diagnosis. The rash can last for more than a week. As the rash fades, the skin around the fingertips, toes, and groin area may peel.
Bisno AL, Stevens DL. Streptococcus pyogenes. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 198.
Gerber MA. Group A Streptococcus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 176.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.