Scarlet fever

Scarlet fever, also called scarlatina, is a bacterial infection caused by streptococcus pyogenes (also called group A streptococci or GAS) characterised by streptococcal tonsillitis, fever, a "strawberry tongue", and a rash.

Clinical features

In addition to features of tonsillitis, a rash and "strawberry tongue" are present.

The rash usually begins 1-2 days after the tonsillitis. It's a generalised maculopapular exanthema which usually begins on the trunk and spreads from there. It's usually sandpaper-like, often easier to palpate than to see. The face is often flaming red, with notable sparing periorally. After 1-2 weeks desquamation occurs, especially on the hands and feet.

The tongue initially gets a white coating, and the papillae undergo hypertrophy, giving a strawberry appearance. Later, the white coating sheds, leaving the tongue red.

Management

Treatment is oral penicillin, same as for streptococcal tonsillitis.‎