Scarlet fever is a reaction to erythrogenic toxins produced by group A haemolytic streptococci (usually streptococcus pyogens).

Epidemiology:

• It is more common in children aged 2-6 yrs old
• Peak incidence: 4 years

Pathophysiology:

• Spread via respiratory route by inhaling or ingesting respiratory droplets or by direct contact with nose and throat discharges (especially sneezing/coughing)
• Usually has an incubation period of 2-4 days

PC

• fever: lasts 24 to 48 hours
• malaise - headache, nausea/vomitting
• sore throat
• ‘strawberry tongue’
• rash
  • fine punctate erythema ('pinhead') which generally appears first on the torso and spares the palms and soles
  • children often have a flushed appearance with circumoral pallor. The rash is often more obvious in the flexures
  • it is often described as having a rough 'sandpaper' texture
  • desquamination occurs later in the course of the illness, particularly around the fingers and toes

Investigations

• Throat swab - Abx therapy should be commenced immediately, rather than waiting for results

Management

• oral penicillin V for 10 days