Acute infectious disease caused by some types of streptococcus bacteria. Fever, sore throat, headache, and, in children, vomiting are followed in two to three days by a rash. The skin peels in about one-third of cases. After a coating disappears, the tongue is swollen, red, and bumpy (strawberry tongue). Glands are usually swollen. Complications frequently involve the sinuses, ears (sometimes with mastoiditis), and neck. Abscesses are common. Nephritis, arthritis, or rheumatic fever may occur later. Treatment involves penicillin, bed rest, and adequate fluid intake. Scarlet fever has become uncommon and much milder since the mid-20th century, independent of the use of antibiotics.
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Diagnosis of scarlet fever is clinical. The blood tests shows marked leukocytosis with neutrophilia and conservated or increased eosinophils, high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and elevation of antistreptolysin O titer. Blood culture is rarely positive, but the streptococci can usually be demonstrated in throat culture. The complications of scarlet fever include septic complications due to spread of streptococcus in blood and immune-mediated complications due to an aberrant immune response. Septic complications, today rare, include ear and sinus infection, streptococcal pneumonia, empyema thoracis, meningitis and full-blown sepsis, upon which the condition may be called malignant scarlet fever.
Immune complications include acute glomerulonephritis, rheumatic fever and erythema nodosum. The secondary scarlatinous disease, or secondary malignant syndrome of scarlet fever, includes renewed fever, renewed angina, septic ear, nose, and throat complications and kidney infection or rheumatic fever and is seen around the eighteenth day of untreated scarlet fever.
Health: The Red Rash of Romantics Scarlet Fever Used to Be a Killer. Today It Is Easily Treated, but a Recent Outbreak Surprised One Family
Feb 09, 1999; A few weeks before Christmas my two-year-old daughter and I were both struck down with what I thought was a particularly nasty...