When your child has a strep throat, there’s a chance that he’ll get a rash known as scarlet fever or scarlatina. The symptoms of scarlet fever begin with a sore throat, a fever of 101 to 104 degrees Fahrenheit (38.2–40 degrees Celsius), and headache. This is followed within twenty-four hours by a red rash covering the trunk, arms, and legs. The rash is slightly raised, which makes the skin feel like fine sandpaper. Your child’s face may turn red, too, with a pale area around his mouth. This redness will disappear in three to five days, leaving peeling skin in the areas where the rash was most intense (neck, underarms, groin, fingers, and toes). He may also have a white coated, then reddened, tongue, and mild abdominal pain.
Call your pediatrician whenever your child complains of a sore throat, especially when a rash or fever also is present. The doctor will examine him and swab his throat to check for strep bacteria. If strep throat is found, an antibiotic (usually penicillin or amoxicillin) will be given. If your child takes the antibiotic by mouth, it’s extremely important to complete the entire course because shorter treatment sometimes results in a return of the disease.
Most children with strep infections respond very quickly to antibiotics. The fever, sore throat, and headache usually are gone within twenty-four hours. The rash, however, will remain for about three to five days.
If your child’s condition does not seem to improve with treatment, notify your pediatrician. If other family members develop a fever or sore throat at this time—with or without a rash—they, too, should be examined and tested for strep throat.
If not treated, scarlet fever (like strep throat) can lead to ear and sinus infections, swollen neck glands, and pus around the tonsils. The most serious complication of untreated strep throat is rheumatic fever, which results in joint pain and swelling and sometimes heart damage. Very rarely, the strep bacteria in the throat can lead to glomerulonephritis, or inflammation of the kidneys, causing blood to appear in the urine and sometimes high blood pressure.