Scarlet Fever (Scarlatina) is an exotoxin-mediated disease caused by Group A streptococcal infection that occurs most often in association with a sore throat and rarely with impetigo or other streptococcal infections. It is characterized by sore throat, fever and a rash over the upper body that may spread to cover almost the entire body. Scarlet fever is not rheumatic fever. Rheumatic fever is the autoimmune disease that occurs after infection with Group A strep that causes damage to the heart valves.
History: This disease was also once known as Scarlatina (from the Italian scarlattina). Many novels depicting life before the nineteenth century describe scarlet fever as an acute disease being followed by many months spent in convalescence. The convalescence was probably due to complications with rheumatic fever. It was also not uncommon to destroy or burn the personal effects of a person afflicted with scarlet fever to prevent transmission to other people.
The disease was once greatly feared and killed many thousands of people. Today, however, it is fairly easy to treat with modern antibiotics.
Signs and symptoms:
The disease is typically preceded by:
- fever
- fatigue
- sore throat
- headache
- vomiting
- There is a characteristic rash:
fine, red, rough-textured and blanches upon pressure
appears 12?48 hours after the fever
generally starts on the chest, axilla (armpits), and behind the ears
worse in the skin folds
astia lines (small linear petechiae) appear and persist after the rash is gone
- Scarlet fever also produces a bright red tongue with a "strawberry" appearance.
- The area around the mouth is usually pale (circumoral pallor)
- After about a week, the skin often desquamates or peels, usually in the groin, axilla, and on tips of fingers and toes
Transmission: The illness is spread by the same means as strep throat.
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