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Scarlet Fever: Sore Throat and a “Sandpapery” Rash in Children

By HERWriter
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Your child has had a pretty bad sore throat for a day or two and then a red splotchy rash appears. First the rash starts on her face and neck but soon spreads to her chest, arms, legs and torso and has a “sandpapery” feel. Your child’s tongue looks red with a whitish film covering it but when you check after a few more days, her tongue has lost the white coating and a “strawberry” color will look very pronounced. These are common symptoms of scarlet fever and your child will need to be seen by a doctor and given antibiotics to fight the infection.

Scarlet fever is caused by group A beta-hemolytic streptococcus, the same bacteria that causes strep throat, and is the result of a reaction to the toxins released by the bacteria. Approximately 10 percent of children who have strep throat develop scarlet fever. Scarlet fever occurs predominantly in children five to15 years old though by the age of 10 most kids have developed antigens against the strep toxins.

Streptococcus is spread via airborne droplets and can be transmitted from infected persons in overcrowded places such as schools. Scarlet fever used to be considered a potentially dangerous disease due to the risk of developing rheumatic fever, a serious heart disorder, but these days treatment with antibiotics has reduced this risk in most people.

How scarlet fever is treated:

1. Typically a throat culture is done to test for streptococcus. A throat culture is 90 percent accurate though other blood test to check for antigen response and blood counts may also be done.

2. A penicillin drug will be prescribed to be given orally for a couple of weeks. Penicillin drugs are the preferred antibiotic choice.

3. To care for the sore throat, salt water gargling may help. Try to increase the child’s intake of fluid with soups, juices and popsicles.

Problems that may appear after having scarlet fever:

Most children improve without incidence and are considered non infectious to others after being on antibiotics for 24 hours. There are some complications that have been found to occur after recovering from scarlet fever that should be monitored.

● Rheumatic fever: Once a large concern, it now is mostly only seen in immigrants to the United States. Approximately three percent of those with scarlet fever develop rheumatic fever. Rheumatic fever can affect joints, skin and the heart. Some people develop muscle weakness or other neurological symptoms.

● Poststreptococcal glomerulonephritis: May occur due to damage to the kidney from the toxins released by the strep bacteria.

● Pandas (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections): Is a disorder where children develop various neurological symptoms such as ADHD, obsessive-compulsive disorder or Tourette’s syndrome. The symptoms may be temporary or last for months.

Other post scarlet fever complications may include infections in other places of the body such as the ear, spine, lungs or skin.

Prompt treatment of strep infections is the best way to avoid developing these complications. Today, most offices and clinics can perform a rapid throat culture strep test with immediate results to diagnose the majority of cases of strep throat. If your or someone else’s child sounds like they have strep throat, make sure they are evaluated by a doctor.



Michele is an R.N. freelance writer with a special interest in woman’s health care and quality of care issues. Other articles by Michele can be read at www.helium.com/users/487540/show_articles

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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