Scarlet Fever

When some kids get a strep infection/strep throat, they will get a variation of the disease presentation in the form of a red sandpaper-like rash on the body with an exaggerated appearance in various skin fold areas (Pastia’s lines). This is classically known as scarlet fever. It can also be accompanied by a very-bright-red slightly swollen tongue that looks like a strawberry. Due to the history of this rash in various English literature over the years, it makes it sound much more scary than it actually is. When your kiddo presents with this classic rash, the pediatrician will let you know that it is most likely due to a strep infection, will treat it with the appropriate antibiotics, and it will go away rather quickly. 

The reason for treating strep throat and scarlet fever promptly with antibiotics is that it can lead to the actually scary condition called rheumatic fever if it is allowed to hang out in the body for too long. Strep bacteria, if allowed to hang out and cause active infection in the body, can (on rare occasions) cause your body to make antibodies that will attack the valves of your heart, damaging the valves rather than the strep bacteria. So we don’t want this to happen, even though the types of strep seen in the US don’t usually cause this reaction. We typically don’t take chances when the heart is involved and will want to treat within a week or so of strep throat or scarlet fever presentation. 

After treatment of scarlet fever, some kids will get some peeling of the hands and feet (like post-sunburn peeling) that is not painful and resolves slowly all by itself.