Diagnosis

During the physical exam, your doctor 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 doctor suspects strep is the cause of your child's illness, he or she will also swab the tonsils and back of your child's throat to collect material that may harbor the strep bacteria.

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

If your child has scarlet fever, your doctor will prescribe an antibiotic. Make sure your child completes the full course of medication. Failure to follow the treatment guidelines may not completely eliminate the infection and will increase your child's risk of developing complications.

Your child can return to school when he or she has taken antibiotics for at least 24 hours and no longer has a fever.

Lifestyle and home remedies

You can take a number of steps to reduce your child's discomfort and pain.

  • Treat fever and pain. Use ibuprofen (Advil, Children's Motrin, others) or acetaminophen (Tylenol, others) to control the fever and minimize throat pain.
  • Provide adequate fluids. Give your child plenty of water to keep the throat moist and prevent dehydration.
  • Prepare a saltwater gargle. If your child is able to gargle water, give him or her salty water to gargle and then spit out. This may ease the throat pain.
  • Humidify the air. Use a cool mist humidifier to eliminate dry air that may further irritate a sore throat.
  • Offer lozenges. Children older than age 4 can suck on lozenges to relieve a sore throat.
  • Provide comforting foods. Warm liquids such as soup and cold treats like ice pops can soothe a sore throat.
  • Avoid irritants. Keep your home free from cigarette smoke and cleaning products that can irritate the throat.

Preparing for your appointment

You're likely to first see your family doctor or your child's pediatrician. However, when you call to set up your appointment, you may be urged to seek immediate medical care if your child is experiencing any of the following:

  • High fever
  • Severe sore throat with difficulty swallowing
  • Intense abdominal pain or vomiting
  • Severe headache

What you can do

Before your appointment, you might want to write a list of questions for the doctor:

  • How soon after my child begins treatment will he or she 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?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor 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?
March 13, 2014
References
  1. Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed Oct. 22, 2013.
  2. Scarlet fever: A group A streptococcal infection. Centers for Disease Control and Prevention. http://www.cdc.gov/Features/ScarletFever/. Accessed Oct. 22, 2013.
  3. Gibofsky A, et al. Epidemiology and pathogenesis of acute rheumatic fever. http://www.uptodate.com/home. Accessed Oct. 22, 2013.
  4. Wessels MR. Streptococcal pharyngitis. New England Journal of Medicine. 2011;364:648.
  5. Van Driel ML, et al. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004406.pub3/abstract. Accessed Oct. 22, 2013.
  6. Get smart: Symptom relief. Centers for Disease Control and Prevention. http://www.cdc.gov/getsmart/antibiotic-use/symptom-relief.html. Accessed Oct. 22, 2013.