Scarlet Fever

Excerpt

Scarlet fever is a rash most commonly associated with bacterial pharyngitis in school-age and adolescent children. It is a blanching, papular rash that is classically described as a “sandpaper” rash. The causative bacteria is Streptococcus pyogenes, which generates an endotoxin mainly responsible for the skin manifestation of the infection. This is further classified as group A and referred to as Group A Strep (GAS). Alone, the rash is not dangerous but is a marker for GAS infection which has suppurative and non-suppurative complications. Therefore, treatment of acute infection is warranted to prevent these complications. The first-line treatment of choice is penicillin. Those allergic to penicillin can be treated with a first-generation cephalosporin. The spread of infection is promoted by mucosal transfer of bacteria to others via an environment of close proximity found in classrooms and similar workplace settings.