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Scarlet Fever

Christina Scartozzi, DO and Leesha A Helm, MD, MPH Reviewed 06/2022
 


BASICS

DESCRIPTION

  • A disease (typically in childhood) characterized by fever, pharyngitis, and rash caused by group A β-hemolytic Streptococcus pyogenes (GAS) that produces erythrogenic toxin

  • Incubation...

DIAGNOSIS

HISTORY

Prodrome 1 to 2 days 
  • Sore throat

  • Headache

  • Myalgias

  • Malaise

  • Fever (>38°C [100.4°F])

  • Vomiting

  • Abdominal pain (may mimic acute abdomen)

  • Rash—scarlatiniform erythematous punctate eruption

  • Coug...

TREATMENT

GENERAL MEASURES

Supportive care; analgesic/antipyretic such as acetaminophen or NSAID, for moderate to severe symptoms or to control fever. Symptomatic treatment can include medicated throat...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Follow-up throat culture not needed unless symptomatic 

Patient Monitoring

GAS is uniformly susceptible to penicillin, treatment failures are typically due to: 
  • Poor...

REFERENCES

1
Kalra  MG, Higgins  KE, Perez  ED. Common questions about streptococcal pharyngitis. Am Fam Physician.  2016; 94(1): 24– 31.  [View Abstract] ...

ADDITIONAL READING

  • Basetti S, Hodgson J, Rawson TM, et al. Scarlet fever: a guide for general practitioners. London J Prim Care (Abingdon). 2017 Aug 11;9(5):77-79.

  • ...

SEE ALSO

  • Pharyngitis

  • Algorithm: Pharyngitis

CODES

ICD10

  • A38.9 Scarlet fever, uncomplicated

  • J02.0 Streptococcal pharyngitis

  • A38.0 Scarlet fever with otitis media

  • A38.8 Scarlet fever with other complications

SNOMED

  • 30242009 Scarlet fever (disorder)

  • 1863...

CLINICAL PEARLS

  • Consider scarlet fever in the differential diagnosis of children with fever and an exanthematous rash.

  • Key clinical findings include strawberry tongue, circumoral pallor, and a coarse s...

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