Diagnosis

During the physical exam, your health care provider will:

  • Look at the condition of your child's throat, tonsils and tongue
  • Feel your child's neck to determine if lymph nodes are enlarged
  • Assess the appearance and texture of the rash

Throat swab

If your health care provider suspects strep is the cause of your child's illness, your provider will swab the tonsils and back of your child's throat to collect material that may have the strep bacteria.

A rapid strep test can identify the bacteria quickly, usually during your child's appointment. If the rapid test is negative, but your health care provider still thinks strep bacteria is the cause of your child's illness, a strep throat culture can be done. It can take longer to get the results of this test.

Tests for the strep bacteria are important because a number of conditions can cause the signs and symptoms of scarlet fever, and these illnesses may require different treatments. If there are no strep bacteria, then some other factor is causing the illness.


Treatment

For scarlet fever, your health care provider will prescribe an antibiotic. Make sure your child takes all of the medication as directed. If your child doesn't follow the treatment guidelines, treatment may not completely eliminate the infection, which can increase your child's risk of developing complications.

Use ibuprofen (Advil, Children's Motrin, others) or acetaminophen (Tylenol, others) to control the fever and minimize throat pain. Check with your child's health care provider about the right dosage.

Your child can return to school after having taken antibiotics for at least 12 hours and no longer having a fever.


Self care

During scarlet fever, you can take several steps to reduce your child's discomfort and pain.

  • Plan plenty of rest. Sleep helps the body fight infection. Have your child rest until feeling better. Also, keep your child at home until there's no sign of fever and antibiotics have been taken for at least 12 hours.
  • Encourage plenty of water. Keeping a sore throat lubricated and moist eases swallowing and helps prevent dehydration.
  • Prepare a saltwater gargle. For older children and adults, gargling several times a day can help relieve throat pain. Mix 1/4 teaspoon (1.5 grams) of table salt in 8 ounces (237 milliliters) of warm water. Be sure to tell your child to spit out the liquid after gargling.
  • Humidify the air. Adding moisture to the air can help ease discomfort. Choose a cool-mist humidifier and clean it daily because bacteria and molds can flourish in some humidifiers. Saline nasal sprays also help keep mucous membranes moist.
  • Offer honey. Honey can be used to soothe sore throats. Don't give honey to children younger than 12 months.
  • Offer soothing foods. Easy-to-swallow foods include soups, applesauce, cooked cereal, mashed potatoes, soft fruits, yogurt and soft-cooked eggs. You can puree foods in a blender to make them easier to swallow. Cold foods, such as sherbet, frozen yogurt or frozen fruit pops, and warm liquids, such as broth, may be soothing. Avoid spicy foods or acidic foods such as orange juice.
  • Avoid irritants. Cigarette smoke can irritate a sore throat. Also avoid fumes from substances that can irritate the throat and lungs. These substances can include paint, cleaning products, incense and essential oils.

Preparing for your appointment

You're likely to first see your family health care provider or your child's pediatrician. However, when you call to set up your appointment, you may be urged to seek immediate medical care.

What you can do

Before your appointment, you might want to make a list of questions for the health care provider. These may include:

  • How soon after starting treatment will my child begin to feel better?
  • Is my child at risk of any long-term complications related to scarlet fever?
  • Is there anything I can do to help soothe my child's skin while it heals?
  • When can my child return to school?
  • Is my child contagious? How can I reduce my child's risk of passing the illness to others?
  • Is there a generic alternative to the medicine you're prescribing? What if my child is allergic to penicillin?

Don't hesitate to ask additional questions during your appointment.

What to expect from your doctor

Your health care provider is likely to ask you a number of questions. Your provider may ask:

  • When did your child begin experiencing symptoms?
  • Has your child had a sore throat or difficulty swallowing?
  • Has your child had a fever? How high was the fever, and how long did it last?
  • Has your child had abdominal pain or vomiting?
  • Has your child been eating adequately?
  • Has your child complained of headache?
  • Has your child recently had a strep infection?
  • Has your child recently been exposed to anyone with a strep infection?
  • Has your child been diagnosed with any other medical conditions?
  • Is your child currently taking any medications?
  • Does your child have medication allergies?

Being ready to answer questions may reserve time to go over any points you want to talk about in-depth.


Jun 07, 2022

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  2. Scarlet fever: All you need to know. Centers for Disease Control and Prevention. https://www.cdc.gov/groupastrep/diseases-public/scarlet-fever.html. Accessed Dec. 21, 2021.
  3. Scarlet fever: Information for clinicians. Centers for Disease Control and Prevention. https://www.cdc.gov/groupastrep/diseases-hcp/scarlet-fever.html. Accessed Dec. 21, 2021.
  4. Streptococcal infections. Merck Manual Professional Version. https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-cocci/streptococcal-infections. Accessed Dec. 21, 2021.
  5. AskMayoExpert. Scarlet fever (child). Mayo Clinic; 2021.
  6. Acute rheumatic fever: Information for clinicians. Centers for Disease Control and Prevention. https://www.cdc.gov/groupastrep/diseases-hcp/acute-rheumatic-fever.html. Dec. 21, 2021.
  7. Sore throat. Centers for Disease Control and Prevention. https://www.cdc.gov/antibiotic-use/sore-throat.html. Accessed Dec. 21, 2021.
  8. Drutz JE. Acute pharyngitis in children and adolescents: Symptomatic treatment. https://www.uptodate.com/contents/search. Accessed Dec. 22, 2021.
  9. Pichichero ME. PANDAS: Pediatric autoimmune neuropsychiatric disorder associated with group A streptococci. https://www.uptodate.com/contents/search. Accessed Dec. 22, 2021.
  10. Ristagno EH (expert opinion). Mayo Clinic. Dec. 23, 2021.

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